A study in China has shown that the combination of enalapril and folic acid protects hypertensive patients better than stroke than enalapril monotherapy, according to Pannochka, an online publication for girls and women aged 14 to 35.. net The study involved 20 thousand patients with hypertension who had not had strokes or other cardiovascular events before..

The results of an interesting scientific work were published in JAMA, and Chinese scientists announced them almost simultaneously at a scientific meeting of the American College of Cardiology held at the end of last week.

Stroke is the No. 1 cause of death in China and the second leading cause of death in the world.. Primary prevention, that is, preventing the first stroke, is especially important because they account for 77% of events. Information on the effectiveness of folic acid in the prevention of stroke has remained uncertain and limited for a long time..

Dr. Yong Huo of Peking University Hospital No. 1, along with his colleagues, enrolled 20,702 patients with hypertension who had no previous strokes or heart attacks.

They were randomly divided into two groups, one (10 354 people. ) of which received only an ACE inhibitor enalapril (10 mg / day), and the second (10 348 people. ) a combination of enalapril (10 mg / day) and folic acid (0.8 mg / day).

The study was conducted from May 2008 to August 2013 in 32 districts of Jiangsu and Anhui Provinces.. All participants were tested for variations in the MTHFR C677T gene (CC, CT, and TT genotypes), which may affect folate metabolism in the body..

During the observation period (on average 4.5 years), the first stroke was registered in 282 participants (2.7%) in the enalapril + folate group and in 355 participants (3.4%) in the enalapril group, which corresponds to an absolute risk reduction by.

The analysis showed a significant reduction in the risk of stroke in the enalapril + folate group for the risk of ischemic stroke (2.2% versus 2.8%) and the overall risk of cardiovascular events (cardiovascular death, heart attack and stroke) - 3.1% against 3,. As for the risk of hemorrhagic stroke, myocardial infarction, death from all causes, there was almost no difference between the groups.

The authors write that this study (China Stroke Primary Prevention Trial, CSPPT), taking into account data on genetic variations of MTHFR and individual folate levels, provides unique information that allows an objective assessment of the effect of folic acid preparations on stroke risk.

“We believe that even in countries where folic acid supplemented foods and nutritional supplements with this vitamin are common, such as the United States and Canada, there may be a place for additional folic acid for the primary prevention of stroke. It’s about targeted therapy, taking into account the specific genotype of patients and the initial level of folate, ”they write.

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