Low circulating folate and vitamin B6 concentrations risk factors for stroke, peripheral vascular disease, and coronary artery disease

Killian Robinson, Kristopher Arheart, Helga Refsum, Lars Brattström, Godfried Boers, Per Ueland, Paolo Rubba, Roberto Palma-Reis, Raymond Meleady, Leslie Daly, Jacqueline Witteman, Ian Graham

Research output: Contribution to journalArticle

465 Citations (Scopus)

Abstract

Background- A high plasma homocysteine concentration is a risk factor for atherosclerosis, and circulating concentrations of homocysteine are related to levels of folate and vitamin B6. This study was performed to explore the interrelationships between homocysteine, B vitamins, and vascular diseases and to evaluate the role of these vitamins as risk factors for atherosclerosis. Methods-In a multicenter case-control study in Europe, 750 patients with documented vascular disease and 800 control subjects frequency- matched for age and sex were compared. Plasma levels of total homocysteine (before and after methionine loading) were determined, as were those of red cell folate, vitamin B12, and vitamin B6. Results- In a conditional logistic regression model, homocysteine concentrations greater than the 80th percentile for control subjects either fasting (12.1 μmol/L) or after a methionine load (38.0 μmol/L) were associated with an elevated risk of vascular disease independent of all traditional risk factors. In addition, concentrations of red cell folate below the lowest 10th percentile (<513 nmol/L) and concentrations of vitamin B6 below the lowest 20th percentile (<23.3 nmol/L) for control subjects were also associated with increased risk. This risk was independent of conventional risk factors and for folate was explained in part by increased homocysteine levels. In contrast, the relationship between vitamin B6 and atherosclerosis was independent of homocysteine levels both before and after methionine loading. Conclusions- Lower levels of folate and vitamin B6 confer an increased risk of atherosclerosis. Clinical trials are now required to evaluate the effect of treatment with these vitamins in the primary and secondary prevention of vascular diseases.

Original languageEnglish
Pages (from-to)437-443
Number of pages7
JournalCirculation
Volume97
Issue number5
StatePublished - Feb 10 1998
Externally publishedYes

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Vitamin B 6
Peripheral Vascular Diseases
Homocysteine
Folic Acid
Coronary Artery Disease
Stroke
Vascular Diseases
Atherosclerosis
Methionine
Vitamins
Logistic Models
Vitamin B Complex
Primary Prevention
Vitamin B 12
Secondary Prevention
Case-Control Studies
Fasting
Clinical Trials

Keywords

  • Atherosclerosis
  • Cerebrovascular disorders
  • Coronary disease
  • Peripheral vascular disease
  • Risk factors

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Robinson, K., Arheart, K., Refsum, H., Brattström, L., Boers, G., Ueland, P., ... Graham, I. (1998). Low circulating folate and vitamin B6 concentrations risk factors for stroke, peripheral vascular disease, and coronary artery disease. Circulation, 97(5), 437-443.

Low circulating folate and vitamin B6 concentrations risk factors for stroke, peripheral vascular disease, and coronary artery disease. / Robinson, Killian; Arheart, Kristopher; Refsum, Helga; Brattström, Lars; Boers, Godfried; Ueland, Per; Rubba, Paolo; Palma-Reis, Roberto; Meleady, Raymond; Daly, Leslie; Witteman, Jacqueline; Graham, Ian.

In: Circulation, Vol. 97, No. 5, 10.02.1998, p. 437-443.

Research output: Contribution to journalArticle

Robinson, K, Arheart, K, Refsum, H, Brattström, L, Boers, G, Ueland, P, Rubba, P, Palma-Reis, R, Meleady, R, Daly, L, Witteman, J & Graham, I 1998, 'Low circulating folate and vitamin B6 concentrations risk factors for stroke, peripheral vascular disease, and coronary artery disease', Circulation, vol. 97, no. 5, pp. 437-443.
Robinson K, Arheart K, Refsum H, Brattström L, Boers G, Ueland P et al. Low circulating folate and vitamin B6 concentrations risk factors for stroke, peripheral vascular disease, and coronary artery disease. Circulation. 1998 Feb 10;97(5):437-443.
Robinson, Killian ; Arheart, Kristopher ; Refsum, Helga ; Brattström, Lars ; Boers, Godfried ; Ueland, Per ; Rubba, Paolo ; Palma-Reis, Roberto ; Meleady, Raymond ; Daly, Leslie ; Witteman, Jacqueline ; Graham, Ian. / Low circulating folate and vitamin B6 concentrations risk factors for stroke, peripheral vascular disease, and coronary artery disease. In: Circulation. 1998 ; Vol. 97, No. 5. pp. 437-443.
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AU - Arheart, Kristopher

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AU - Boers, Godfried

AU - Ueland, Per

AU - Rubba, Paolo

AU - Palma-Reis, Roberto

AU - Meleady, Raymond

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AU - Witteman, Jacqueline

AU - Graham, Ian

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