Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Folate, also known as vitamin B9, has been studied for its role in cardiovascular disease (CVD) prevention and management, primarily due to its ability to reduce homocysteine levels in the blood. Elevated homocysteine is considered a potential risk factor for atherosclerosis and other cardiovascular conditions. Folate functions as a coenzyme in the remethylation of homocysteine to methionine, helping to keep homocysteine levels within a healthy range.

Several large-scale epidemiological studies have observed an association between higher homocysteine levels and increased risk of CVD, leading to the hypothesis that folate supplementation could reduce risk by lowering homocysteine. Randomized controlled trials (RCTs), such as the HOPE-2 and NORVIT trials, have demonstrated that folic acid (with or without B12 and B6) effectively lowers homocysteine concentrations. However, these same trials found little to no effect on reducing cardiovascular events like heart attacks or strokes in populations with established CVD.

Despite the lack of strong evidence for secondary prevention, some meta-analyses suggest a potential modest benefit in primary prevention, particularly in regions with low baseline folate intake and no folic acid food fortification. The evidence is stronger for stroke reduction than for coronary heart disease. Thus, current guidelines generally do not recommend folate supplementation solely for CVD prevention in the general population, but it may be considered in specific contexts. Overall, the scientific justification exists primarily for homocysteine lowering, but translation into reduced cardiovascular events remains uncertain.

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Other health conditions supported by folate

Products containing folate

Thorne 5-MTHF 1 mg Folate
Thorne 5-MTHF 5 mg Folate
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