Folate Improves Endothelial Function in Patients with Coronary Heart Disease
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Sagar Doshi
Abstract
Elevated plasma homocysteine is associated with increased cardiovascular risk but it remains unproven that the effect is directly causal. Folate and homocysteine metabolism are closely linked such that administration of folic acid in doses ranging from 0.2–10 mg/day lowers plasma total homocysteine (tHcy) by up to 25%. Folic acid has been widely advocated as a therapy which may reduce cardiovascular risk, but the clinical benefit remains as yet unproven and the choice of dose remains unclear. The effect of folic acid on endothelial function has been investigated in patients with proven coronary heart disease (CHD) by measuring flow-mediated dilatation (FMD) in the brachial artery. Oral folic acid (5 mg/day) markedly enhances endothelial function (FMD) and lowers homocysteine. Studies of the acute effects of folic acid have shown that this improvement occurs within the first 2–4 hours following the first dose, at which times there was no significant reduction in plasma tHcy. Administration of 5-methyltetrahydrofolate directly into the brachial artery markedly enhances FMD, an effect that is blocked by monomethyl arginine (LNMMA), suggesting that the effects of folate are mediated by nitric oxide. This Review summarises studies which show that pharmacological doses of folate markedly enhance endothelial function in patients with CHD. The discordance with changes in plasma homocysteine suggests that these effects may occur by mechanisms distinct from homocysteine lowering.
Copyright © 2003 by Walter de Gruyter GmbH & Co. KG
Artikel in diesem Heft
- Where Are We Standing in Homocysteine Research?
- DACH-LIGA Homocystein (German, Austrian and Swiss Homocysteine Society): Consensus Paper on the Rational Clinical Use of Homocysteine, Folic Acid and B-Vitamins in Cardiovascular and Thrombotic Diseases: Guidelines and Recommendations
- Hyperhomocysteinaemia as a Risk Factor for Venous Thrombosis: An Update of the Current Evidence
- Does Homocysteine Cause Hypertension?
- Homocysteine Metabolism in Renal Disease
- Hyperhomocysteinemia and B-Vitamin Deficiencies in Infants and Children
- The Role of Genetic Factors in the Development of Hyperhomocysteinemia
- New Basis of the Neurotrophic Action of Vitamin B12
- Hyperhomocysteinemia and Immune Activation
- Interactions of Homocysteine, Nitric Oxide, Folate and Radicals in the Progressively Damaged Endothelium
- Influence of Hyperhomocysteinemia on the Cellular Redox State – Impact on Homocysteine-Induced Endothelial Dysfunction
- Homocysteine-Thiolactone and S-Nitroso-Homocysteine Mediate Incorporation of Homocysteine into Protein in Humans
- Association of Asymmetric Dimethylarginine and Endothelial Dysfunction
- Genetic Determinants of Folate and Vitamin B12 Metabolism: A Common Pathway in Neural Tube Defect and Down Syndrome?
- Functional Vitamin B12 Deficiency and Determination of Holotranscobalamin in Populations at Risk
- Holotranscobalamin as a Predictor of Vitamin B12 Status
- Hyperhomocysteinemia and B-Vitamin Status after Discontinuation of Oral Anticoagulation Therapy in Patients with a History of Venous Thromboembolism
- Measurement of Carotid Plaque and Effect of Vitamin Therapy for Total Homocysteine
- Folate Improves Endothelial Function in Patients with Coronary Heart Disease
- The Impact of Hyperhomocysteinemia as a Cardiovascular Risk Factor in the Prediction of Coronary Heart Disease
- Homocysteine Increases during Endurance Exercise
- Comparison of the Influence of Volume-Oriented Training and High-Intensity Interval Training on Serum Homocysteine and Its Cofactors in Young, Healthy Swimmers
- Analysis of the Transcobalamin II 776C>G (259P>R) Single Nucleotide Polymorphism by Denaturing HPLC in Healthy Elderly: Associations with Cobalamin, Homocysteine and Holo-Transcobalamin II
- Meetings and Awards
Artikel in diesem Heft
- Where Are We Standing in Homocysteine Research?
- DACH-LIGA Homocystein (German, Austrian and Swiss Homocysteine Society): Consensus Paper on the Rational Clinical Use of Homocysteine, Folic Acid and B-Vitamins in Cardiovascular and Thrombotic Diseases: Guidelines and Recommendations
- Hyperhomocysteinaemia as a Risk Factor for Venous Thrombosis: An Update of the Current Evidence
- Does Homocysteine Cause Hypertension?
- Homocysteine Metabolism in Renal Disease
- Hyperhomocysteinemia and B-Vitamin Deficiencies in Infants and Children
- The Role of Genetic Factors in the Development of Hyperhomocysteinemia
- New Basis of the Neurotrophic Action of Vitamin B12
- Hyperhomocysteinemia and Immune Activation
- Interactions of Homocysteine, Nitric Oxide, Folate and Radicals in the Progressively Damaged Endothelium
- Influence of Hyperhomocysteinemia on the Cellular Redox State – Impact on Homocysteine-Induced Endothelial Dysfunction
- Homocysteine-Thiolactone and S-Nitroso-Homocysteine Mediate Incorporation of Homocysteine into Protein in Humans
- Association of Asymmetric Dimethylarginine and Endothelial Dysfunction
- Genetic Determinants of Folate and Vitamin B12 Metabolism: A Common Pathway in Neural Tube Defect and Down Syndrome?
- Functional Vitamin B12 Deficiency and Determination of Holotranscobalamin in Populations at Risk
- Holotranscobalamin as a Predictor of Vitamin B12 Status
- Hyperhomocysteinemia and B-Vitamin Status after Discontinuation of Oral Anticoagulation Therapy in Patients with a History of Venous Thromboembolism
- Measurement of Carotid Plaque and Effect of Vitamin Therapy for Total Homocysteine
- Folate Improves Endothelial Function in Patients with Coronary Heart Disease
- The Impact of Hyperhomocysteinemia as a Cardiovascular Risk Factor in the Prediction of Coronary Heart Disease
- Homocysteine Increases during Endurance Exercise
- Comparison of the Influence of Volume-Oriented Training and High-Intensity Interval Training on Serum Homocysteine and Its Cofactors in Young, Healthy Swimmers
- Analysis of the Transcobalamin II 776C>G (259P>R) Single Nucleotide Polymorphism by Denaturing HPLC in Healthy Elderly: Associations with Cobalamin, Homocysteine and Holo-Transcobalamin II
- Meetings and Awards
