Vitamins Don't Stop Second Stroke
High-Dose B Vitamins Fail to Improve Second-Stroke Rates
Feb. 3, 2004 -- People at high risk of stroke and heart attack are advised to take vitamin B in their diets. But high-dose B vitamins won't prevent a second stroke in most people, new research shows.
The disappointing finding comes from the U.S. Vitamin Intervention for Stroke Prevention study of nearly 3,700 men and women who suffered a first stroke. The study added high- or low-dose B vitamins -- folate, vitamin B-12, and vitamin B-6 -- to state-of-the-art medical care for two years.
The bottom line: Recurrent stroke was still far too common. James F. Toole, MD, of Wake Forest University in Winston-Salem, N.C., is the primary author of the report in the Feb. 4 issue of The Journal of the American Medical Association.
"High-dose vitamin therapy had no effect on the outcome measures of stroke, coronary heart disease events, or death," Toole and colleagues conclude.
The risk of heart disease and stroke goes way up when a person has high blood levels of a compound called homocysteine. B vitamins lower homocysteine.
So why did the study fail to find an effect? The study included people whose homocysteine levels were in the top 25%. For most study participants, these levels may have been too low for vitamins to have much of an effect.
And because high homocysteine takes years to cause disease, the study may not have treated patients long enough to reverse the harm.
In an editorial accompanying the study, Johns Hopkins researcher Daniel F. Hanley, MD, says the idea of treating stroke patients with B vitamins needs more study.
"Further investigation should lead to a better understanding of which patients to treat [with B vitamins] and how vigorously to treat them," he writes.
Vitamins Don't Stop Second Stroke
High-Dose B Vitamins Fail to Improve Second-Stroke Rates
Feb. 3, 2004 -- People at high risk of stroke and heart attack are advised to take vitamin B in their diets. But high-dose B vitamins won't prevent a second stroke in most people, new research shows.
The disappointing finding comes from the U.S. Vitamin Intervention for Stroke Prevention study of nearly 3,700 men and women who suffered a first stroke. The study added high- or low-dose B vitamins -- folate, vitamin B-12, and vitamin B-6 -- to state-of-the-art medical care for two years.
The bottom line: Recurrent stroke was still far too common. James F. Toole, MD, of Wake Forest University in Winston-Salem, N.C., is the primary author of the report in the Feb. 4 issue of The Journal of the American Medical Association.
"High-dose vitamin therapy had no effect on the outcome measures of stroke, coronary heart disease events, or death," Toole and colleagues conclude.
The Villain: Homocysteine
The risk of heart disease and stroke goes way up when a person has high blood levels of a compound called homocysteine. B vitamins lower homocysteine.
So why did the study fail to find an effect? The study included people whose homocysteine levels were in the top 25%. For most study participants, these levels may have been too low for vitamins to have much of an effect.
And because high homocysteine takes years to cause disease, the study may not have treated patients long enough to reverse the harm.
In an editorial accompanying the study, Johns Hopkins researcher Daniel F. Hanley, MD, says the idea of treating stroke patients with B vitamins needs more study.
"Further investigation should lead to a better understanding of which patients to treat [with B vitamins] and how vigorously to treat them," he writes.
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