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Pearl Toh, 27 Mar 2020
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Add-on folic acid treatment confers stroke-free survival gains in hypertensive patients

15 Jan 2020

The use of folic acid in addition to enalapril in the treatment of patients with hypertension yields a modest increase in lifetime stroke-free survival, a study has found.

Add-on folic acid therapy has been previously shown to be more effective than enalapril monotherapy at reducing the risk of first stroke in hypertensive patients enrolled in the China Stroke Primary Prevention Trial (CSPPT).

In the current analysis, researchers used data from 19,053 participants (mean age, 60.8 years; 41.1 percent male) of the CSPPT and established adjusted models for competing risks and an age-based time scale to estimate lifetime incremental stroke-free survival for the enalapril–folic acid combo vs enalapril alone.

In the cohort, 23.7 percent of patients were actively smoking and 24.0 percent consumed alcohol. The respective mean systolic and diastolic blood pressure levels were 167.2 and 93.7 mm Hg at baseline and 139.4 and 82.6 mm Hg during treatment.

Projected median lifetime stroke-free survival was longer by 1.75 months (interquartile range, 0.73–2.39) with the combination of enalapril plus folic acid treatment vs enalapril alone. The maximum survival gain was up to 12.95 months.

Subgroup analyses showed that the beneficial effect of the enalapril–folic acid combo on stroke-free survival was greater in patients who were younger, male, with lower baseline folate levels, higher baseline systolic blood pressure, higher baseline total cholesterol and blood glucose, and with MTHFR (methylenetetrahydrofolate reductase) C677T CT or TT genotype.

The study suggests that even a moderate gain may translate into a gain of millions of stroke-free months, according to the researchers. This finding should help clinicians and patients to make informed decisions on stroke prevention.

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Most Read Articles
Pearl Toh, 27 Mar 2020
Every-two-month injections of the long-acting cabotegravir + rilpivirine were noninferior to once-monthly injections for virologic suppression at 48 weeks in people living with HIV*, according to the ATLAS-2M** study presented at CROI 2020 — thus providing a potential option with more convenient dosing.
3 days ago
Being overweight or obese in adolescence appears to increase the risk of papillary thyroid cancer in adulthood, a recent study has shown.
Stephen Padilla, 19 Mar 2020
The assumption that children are less vulnerable to the coronavirus disease 2019 (COVID-19) compared to adults is not quite true and may even be dangerous, suggests a recent study.
Tristan Manalac, 6 days ago
While the 2019 coronavirus disease (COVID-19) is generally mild in children, infants appear to be particularly susceptible to severe and critical infections, a new study has found.