Folic Acid, Vitamin B12 Show Potential as Heart Disease Treatments

August 21, 2001
News Office: Bill Gordon (415) 502-6397

Red wine and garlic aren't the only dietary supplements that keep our hearts healthy. Folic acid and vitamin B12 also appear to offer cost-effective treatments for heart disease and the reduction of associated deaths among the adult U.S. population, according to projections in a new UCSF Medical Center study published in the Aug. 22 edition of the Journal of American Medical Association (JAMA).

"The evidence for the beneficial effects of vitamins B12 and folic acid is much stronger than for garlic, vitamin E, and other dietary supplements promoted for heart disease prevention," says Dr. Jeffrey A. Tice, an internist at UCSF Medical center and principal investigator of the study.

UCSF researchers studied available data on the U.S population's homocysteine levels, a strong indicator of heart disease risk and associated death. Tice, a UCSF assistant adjunct professor of medicine, noted that previous studies demonstrated that people with modestly elevated homocysteine levels have higher rates of stroke, heart attack and death from heart disease compared to those with low to normal homocysteine levels.

In addition, recent randomized clinical trials have shown that folic acid significantly lowered homocysteine levels by 25 percent and that the addition of vitamin B12 lowered levels an additional 7 percent. Moreover, homocysteine levels in the U.S. population have fallen since the Food and Drug Administration (FDA) mandated in 1998 that all enriched grain products in the U.S. contain 140 ug of folic acid per 100 g.

Using a computer model, UCSF researchers projected the effects of folic acid and vitamin B12 on the homocysteine levels of all women and men 35 to 84 years old if treated with these dietary supplements over a 10-year period from 2001 to 2011. The costs of using folic acid and B12 vitamins to further lower homocysteine levels also were studied.

Assuming that the U.S. population consumes their daily dose of grains enriched with the FDA's folic acid requirement over a 10-year period (2001-2011), the UCSF study estimated that heart disease rates and deaths will decrease by 8 percent in women and 13 percent in men.

Among the U.S. population with known heart disease and elevated homocysteine levels, 310,000 fewer heart disease related deaths are projected to occur over a 10-year period if these people add a folic acid (1 mg) and vitamin B12 (0.5) supplement to their daily dose of folic acid enriched grains, rather than consuming folic acid enriched grains alone.

The UCSF study also found that administering daily folic acid and vitamin B12 supplements to everyone with heart disease, as well as to men 45 years and older without heart disease, should save money. In women 55 years and older without heart disease, the cost of vitamin therapy would be low compared to other treatments currently used.

"For most people, especially those with heart disease, taking a folic acid and vitamin B12 supplement is projected not only to be safe and save lives, but also to save money because it prevents heart disease and the costs associated with expensive medical treatments and procedures," said Dr. Lee Goldman, a cardiovascular specialist at UCSF Medical Center, senior author of the study and professor and chair of the UCSF Department of Medicine.

Goldman added that a projected $24 billion in the United States would be saved between 2001 and 2011 by treating men and women with heart disease with folic acid and vitamin B12.

Other researchers participating in the study include Pamela Coxson, UCSF; Paula A. Goldman, Milton C. Weinstein and Lawrence Williams, all of the Harvard School of Public Health, Boston; Dr. M.G. Myriam Hunink, Dr. Irwin Rosenberg and Dr. Elizabeth Ross, all of Tufts University.