01-07-2009, 11:40 PM
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B-Vitamins May Slow Atherosclerosis Progression
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B complex supplements reduce atherosclerosis progression in individuals with elevated homocysteine
An article published online on December 31, 2008 in the journal Stroke revealed the finding of the B-Vitamin Atherosclerosis Intervention Trial (BVAIT) of an inhibitory effect of high dose B vitamin supplementation on the progression of atherosclerosis among men and women with high homocysteine levels.
Howard N Hodis, MD, of the University of Southern California and colleagues assigned 506 men and postmenopausal women without cardiovascular disease who had an initial total homocysteine level of greater than 8.5 micromoles per liter to receive 5 milligrams folic acid, 50 milligrams vitamin B6 and 400 micrograms vitamin B12, or a placebo daily for an average of 3.1 years. Atherosclerosis was assessed via evaluation of carotid artery intima media thickness (CIMT), and fasting and post-methionine loading homocysteine levels were measured, upon enrollment and every six months.
Homocysteine levels decreased in subjects who received B vitamins, while an increase occurred in the placebo group. Post methionine loading homocysteine levels were found to be associated with carotid intima media thickness progression. When the entire group was considered, a reduction in the rate of the progression in carotid artery intima media thickness was associated with B vitamin supplementation, although the difference was not considered statistically significant. However, among participants whose homocysteine levels at the beginning of the study were at least 9.1 micromoles per liter, those in the placebo group had twice the rate of carotid artery intima media thickness progression than that observed among those who received B vitamins.
The authors suggest that the difference between the current trial's results and those of similar studies that did not find significant effects for B vitamins "may be the result of different timing of B vitamin supplementation according to the stage (early versus advanced) of atherosclerosis." They conclude that, "Further studies to determine whether reducing total homocysteine levels prevents plaque rupture and clinical events in a population similar to BVAIT are warranted.
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