Study Finds Folic Acid May Play Role in Stroke Prevention

A new study published in the Journal of the American Medical Association suggests that supplementing folic acid with medication for high blood pressure may play a role in preventing stroke among adults with hypertension.¹ 

The research, dubbed the China Stroke Primary Prevention Trial (CSPPT), included more than 20,000 adults in China with no history of heart attack or stroke. The findings could potentially benefit billions around the world and someday be a contributor to primary prevention, according to a JAMA news release.² 

Once more research is conducted, pharmacy technology could potentially be utilized to include folic acid in more drugs.

Research and Findings

The research team notes that the CSPPT is the first large-scale trial focused on using folic acid as a preventative measure against stroke.² Over a median treatment time of 4.5 years, beginning May 19, 2008 and ending August 24, 2013, approximately 20,700 people participated in the double-blind study.¹ Those included in the study were given randomized treatment that either exclusively contained enalapril, a high blood pressure drug, or a mix of enalapril and folic acid.

Those in the enalapril and folic acid group had a notably reduced risk in stroke, only 2.7 percent in comparison to 3.4 percent of those in the enalapril group.¹ Researchers found particularly promising results in regard to ischemic strokes, which are responsible for the vast majority of strokes.

According to JAMA, stroke is the No. 1 cause of death in China and the second leading cause of death around the world.² Preventing first strokes is important because 77 percent are first events.² 

In the published paper, the authors write, “We speculate that even in countries with folic acid fortification and widespread use of folic acid supplements such as in the United States and Canada, there may still be room to further reduce stroke incidence using more targeted folic acid therapy—in particular, among those with the TT genotype and low or moderate folate levels.”¹ 

Folic acid is naturally found in a wide range of foods, including leafy greens, beans, nuts and fruits, according to Business Insider.³ 

¹ “Efficacy of Folic Acid Therapy in Primary Prevention of Stroke Among Adults With Hypertension in China: The CSPPT Randomized Clinical Trial,” by Yong Huo, Jianping Li, et al., the Journal of the American Medical Association, March 15, 2015. http://jama.jamanetwork.com/article.aspx?articleid=2205876&resultClick=1

² “Folic Acid Supplementation Among Adults with Hypertension Reduces Risk of Stroke,” Journal of the American Medical Association, March 15, 2015. http://media.jamanetwork.com/news-item/folic-acid-supplementation-among-adults-with-hypertension-reduces-risk-of-stroke/

³ “Folic acid plus blood pressure drug lowers stroke risk: study,” Business Insider, March 15, 2015. http://www.businessinsider.com/afp-folic-acid-plus-blood-pressure-drug-lowers-stroke-risk-study-2015-3