Efficacy of folic acid supplementation in stroke prevention: a meta-analysis

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Efficacy of folic acid supplementation in stroke prevention: a meta-analysis

Wang et al., 2007 | Lancet | Meta Analysis

Citation

Wang Xiaobin, Qin Xianhui, ... Xu Xiping. Efficacy of folic acid supplementation in stroke prevention: a meta-analysis. Lancet. 2007-Jun-02;369(9576):1876-1882. doi:10.1016/S0140-6736(07)60854-X

Abstract

BACKGROUND: The efficacy of treatments that lower homocysteine concentrations in reducing the risk of cardiovascular disease remains controversial. Our aim was to do a meta-analysis of relevant randomised trials to assess the efficacy of folic acid supplementation in the prevention of stroke. METHODS: We collected data from eight randomised trials of folic acid that had stroke reported as one of the endpoints. Relative risk (RR) was used as a measure of the effect of folic acid supplementation on the risk of stroke with a random effect model. The analysis was further stratified by factors that could affect the treatment effects. FINDINGS: Folic acid supplementation significantly reduced the risk of stroke by 18% (RR 0.82, 95% CI 0.68-1.00; p=0.045). In the stratified analyses, a greater beneficial effect was seen in those trials with a treatment duration of more than 36 months (0.71, 0.57-0.87; p=0.001), a decrease in the concentration of homocysteine of more than 20% (0.77, 0.63-0.94; p=0.012), no fortification or partly fortified grain (0.75, 0.62-0.91; p=0.003), and no history of stroke (0.75, 0.62-0.90; p=0.002). In the corresponding comparison groups, the estimated RRs were attenuated and insignificant. INTERPRETATION: Our findings indicate that folic acid supplementation can effectively reduce the risk of stroke in primary prevention.

Key Findings

Folic acid supplementation significantly reduced the risk of stroke by 18% (RR 0.82, 95% CI 0.68-1.00; p=0.045). In the stratified analyses, a greater beneficial effect was seen in those trials with a treatment duration of more than 36 months (0.71, 0.57-0.87; p=0.001), a decrease in the concentration of homocysteine of more than 20% (0.77, 0.63-0.94; p=0.012), no fortification or partly fortified grain (0.75, 0.62-0.91; p=0.003), and no history of stroke (0.75, 0.62-0.90; p=0.002). In the corre

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Aged
  • Female
  • Folic Acid
  • Homocysteine
  • Humans
  • Male
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Risk
  • Stroke
  • Vitamin B Complex

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Review
  • Vertical: folate

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09