scholarly journals Folic Acid in Stroke Prevention in Countries without Mandatory Folic Acid Food Fortification: A Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 20 (1) ◽  
pp. 99-109 ◽  
Author(s):  
Chia-Yu Hsu ◽  
Shao-Wen Chiu ◽  
Keun-Sik Hong ◽  
Jeffrey L. Saver ◽  
Yi-Ling Wu ◽  
...  
Keyword(s):  
Folic Acid ◽  
Randomized Controlled Trials ◽  
Stroke Prevention ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Food Fortification ◽  
Randomized Controlled

scholarly journals The effect of folate fortification on folic acid-based homocysteine-lowering intervention and stroke risk: a meta-analysis

2014 ◽  
Vol 18 (8) ◽  
pp. 1514-1521 ◽  
Author(s):  
Rui Zeng ◽  
Chun-Hua Xu ◽  
Yuan-Ning Xu ◽  
Ya-Li Wang ◽  
Mian Wang
Keyword(s):  
Folic Acid ◽  
Randomized Controlled Trials ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Folic Acid Supplementation ◽  
Folate Intake ◽  
Controlled Trials ◽  
Acid Supplementation ◽  
Randomized Controlled ◽  
Significant Difference

AbstractObjectiveFolate and vitamin B12 are two vital regulators in the metabolic process of homocysteine, which is a risk factor of atherothrombotic events. Low folate intake or low plasma folate concentration is associated with increased stroke risk. Previous randomized controlled trials presented discordant findings in the effect of folic acid supplementation-based homocysteine lowering on stroke risk. The aim of the present review was to perform a meta-analysis of relevant randomized controlled trials to check the how different folate fortification status might affect the effects of folic acid supplementation in lowering homocysteine and reducing stroke risk.DesignRelevant randomized controlled trials were identified through formal literature search. Homocysteine reduction was compared in subgroups stratified by folate fortification status. Relative risks with 95 % confidence intervals were used as a measure to assess the association between folic acid supplementation and stroke risk.SettingThe meta-analysis included fourteen randomized controlled trials,SubjectsA total of 39 420 patients.ResultsHomocysteine reductions were 26·99 (sd 1·91) %, 18·38 (sd 3·82) % and 21·30 (sd 1·98) %, respectively, in the subgroups without folate fortification, with folate fortification and with partial folate fortification. Significant difference was observed between the subgroups with folate fortification and without folate fortification (P=0·05). The relative risk of stroke was 0·88 (95 % CI 0·77, 1·00, P=0·05) in the subgroup without folate fortification, 0·94 (95 % CI 0·58, 1·54, P=0·82) in the subgroup with folate fortification and 0·91 (95 % CI 0·82, 1·01, P=0·09) in the subgroup with partial folate fortification.ConclusionsFolic acid supplementation might have a modest benefit on stroke prevention in regions without folate fortification.

scholarly journals Efficacy of Supplementation with B Vitamins for Stroke Prevention: A Network Meta-Analysis of Randomized Controlled Trials

PLoS ONE ◽  
2015 ◽  
Vol 10 (9) ◽  
pp. e0137533 ◽  
Author(s):  
Hongli Dong ◽  
Fuhua Pi ◽  
Zan Ding ◽  
Wei Chen ◽  
Shaojie Pang ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Stroke Prevention ◽  
Meta Analysis ◽  
B Vitamins ◽  
Controlled Trials ◽  
Randomized Controlled

scholarly journals Role of Blood Pressure Management in Stroke Prevention: A Systematic Review and Network Meta-Analysis of 93 Randomized Controlled Trials

2021 ◽  
Vol 23 (1) ◽  
pp. 1-11
Author(s):  
Xiao-Ling Zhong ◽  
Yi Dong ◽  
Wei Xu ◽  
Yu-Yuan Huang ◽  
Hui-Fu Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trials ◽  
Stroke Prevention ◽  
Meta Analysis ◽  
Antihypertensive Agents ◽  
Tolerability Profile ◽  
Controlled Trials ◽  
Converting Enzyme Inhibitors ◽  
Randomized Controlled ◽  
Pairwise Analysis

Background and Purpose The present study aimed to compare the efficacy and tolerability of different blood pressure (BP)-lowering strategies.Methods Randomized controlled trials that compared various antihypertensive treatments and stroke outcomes were included. Eligible trials were categorized into three scenarios: single or combination antihypertensive agents against placebos; single or combination agents against other agents; and different BP-lowering targets. The primary efficacy outcome was the risk reduction pertaining to strokes. The tolerability outcome was the withdrawal of drugs, owing to drug-related side effects (PROSPERO registration number CRD42018118454 [20/12/2018]).Results The present study included 93 trials (average follow-up duration, 3.3 years). In the pairwise analysis, angiotensin-converting enzyme inhibitors (ACEis) and beta-blockers (BBs) were inferior to calcium channel blockers (CCBs) (odds ratio [OR], 1.123; 95% confidence interval [CI], 1.008 to 1.252) (OR, 1.261; 95% CI, 1.116 to 1.425) for stroke prevention, BB was inferior to angiotensin II receptor blockers (ARB) (OR, 1.361; 95% CI, 1.142 to 1.622), and diuretics were superior to ACEi (OR, 0.871; 95% CI, 0.771 to 0.984). The combination of ACEi+CCB was superior to ACEi+diuretic (OR, 0.892; 95% CI, 0.823 to 0.966). The network meta-analysis confirmed that diuretics were superior to BB (OR, 1.34; 95% CI, 1.11 to 1.58), ACEi+diuretic (OR, 1.47; 95% CI, 1.02 to 2.08), BB+CCB (OR, 2.05; 95% CI, 1.05 to 3.79), and renin inhibitors (OR, 1.87; 95% CI, 1.25 to 2.75) for stroke prevention. Regarding the tolerability profile, the pairwise analysis revealed that ACEi was inferior to CCB and less tolerable, compared to the other treatments.Conclusions Monotherapy using diuretics, CCB, or ARB, and their combinations could be employed as first-line treatments for stroke prevention in terms of efficacy and tolerability.

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