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Folate Supplements for Stroke Prevention Targeted Trial Trumps the Rest
The effect of folate supplementation on cardiovascular disease has been studied in many observational studies and randomized trials and has been a topic of debate for a number of years. In this issue of JAMA, Huo and colleagues provide results from their important clinical trial of folic acid therapy for primary prevention of stroke. In a carefully designed and executed randomized trial, 20 702 adults with hypertension were randomized to receive enalapril alone (n = 10 354) or enalapril combined with 0.8 mg folic acid (n = 10 348). As recommended by the data and safety monitoring board, the trial was terminat...
Source: JAMA - Journal of the American Medical Association - March 15, 2015 Category: Journals (General) Source Type: research

Cost-effectiveness of folic acid therapy for primary prevention of stroke in patients with hypertension
For hypertensive patients without a history of stroke or myocardial infarction (MI), the China Stroke Primary Prevention Trial (CSPPT) demonstrated that treatment with enalapril-folic acid reduced the risk of ...
Source: BMC Medicine - October 25, 2022 Category: Internal Medicine Authors: Tiantian Zhang, Zhuoru Liang, Tengfei Lin, David J. Cohen, Alejandro Arrieta, Xiaobin Wang, Xianhui Qin, Binyan Wang, Yong Huo, Gordon G. Liu, Jie Jiang and Zugui Zhang Tags: Research article Source Type: research

In Chinese adults with hypertension, adding folic acid to enalapril reduced incident stroke.
PMID: 26192588 [PubMed - in process]
Source: Annals of Internal Medicine - July 21, 2015 Category: Internal Medicine Authors: Barer D Tags: Ann Intern Med Source Type: research

Perindopril increases the swallowing reflex by inhibiting substance P degradation and tyrosine hydroxylase activation in a rat model of dysphagia.
Abstract Patients with hypertension have a high risk of ischemic stroke and subsequent stroke-associated pneumonia. Stroke-associated pneumonia is most likely to develop in patients with dysphagia. The present study was designed to compare the ameliorative effects of different treatments in rat model of dysphagia. Spontaneously hypertensive rats were treated with bilateral common carotid artery occlusion (BCAO) to induce chronic cerebral hypoperfusion causing disorders of the swallowing reflex. Angiotensin-converting enzyme (ACE) inhibitors (perindopril, imidapril and enalapril), an angiotensin II type 1-receptor ...
Source: European Journal of Pharmacology - November 12, 2014 Category: Drugs & Pharmacology Authors: Ikeda JI, Kojima N, Saeki K, Ishihara M, Takayama M Tags: Eur J Pharmacol Source Type: research

In Context News in brief
Folic acid can reduce risk of first stroke, according to the results of a double-blind trial. 20 702 people with hypertension without a history of stroke or myocardial infarction enrolled in the China Stroke Primary Prevention Trial were randomly assigned to receive either combined enalapril 10 mg and folic acid 0·8 mg or enalapril 10 mg alone. The trial was terminated early, after a median of 4·5 years, when benefits of the combined treatment were identified: there was a significant reduction in risk of first stroke in the folic acid-enalapril group (hazard ratio 0·79, 95% CI 0·68–0·93) compared with enalapril alone group.
Source: Lancet Neurology - April 13, 2015 Category: Neurology Tags: In Context Source Type: research

Effect of folic acid supplementation on cancer risk among adults with hypertension in China: A randomized clinical trial
This article is protected by copyright. All rights reserved.
Source: International Journal of Cancer - March 17, 2016 Category: Cancer & Oncology Authors: Xianhui Qin, Lin Shen, Rong Zhang, Youbao Li, Xiaobin Wang, Binyan Wang, Xiaodong Jiang, Hua Jiang, Yu Lei, Fan Fan Hou, Jin Gu, Yong Huo Tags: Research Article Source Type: research

Effect of folic acid supplementation on risk of new‐onset diabetes in adults with hypertension in China: Findings from the CSPPT
ConclusionsAmong adults with hypertension with no history of stroke and/or MI in China, folic acid supplementation had no significant effect on the risk of new‐onset diabetes. This article is protected by copyright. All rights reserved.
Source: Journal of Diabetes - October 11, 2015 Category: Endocrinology Authors: Xianhui Qin, Jianping Li, Yan Zhang, Dafang Chen, Binyan Wang, Mingli He, Jia Fu, Genfu Tang, Yefeng Cai, Xiuli Shi, Xin Xu, Fan Fan Hou, Xiaobin Wang, Yong Huo Tags: Original Article Source Type: research

Time to Think About Nutrient Needs in Chronic Disease
There is renewed interest in health benefits of folic acid supplementation since the China Stroke Prevention Primary Prevention Trial (CSPPT) showed the potential benefits of folic acid in preventing stroke in Chinese adults with hypertension. It has long been known that folic acid prevents neural tube defects, which are among the most severe and debilitating congenital birth defects worldwide. The CSPPT was terminated early when 800 µg of folic acid in combination with 10 mg of enalapril significantly reduced primary stroke incidence compared with the enalapril alone treatment arm. This finding was unexpected as other st...
Source: JAMA Internal Medicine - August 22, 2016 Category: Internal Medicine Source Type: research

Critical Blood Pressure Threshold Dependence of Hypertensive Injury and Repair in a Malignant Nephrosclerosis Model Kidney
Most patients with essential hypertension do not exhibit substantial renal damage. Renal autoregulation by preventing glomerular transmission of systemic pressures has been postulated to mediate this resistance. Conversely, malignant nephrosclerosis (MN) has been postulated to develop when severe hypertension exceeds a critical ceiling. If the concept is valid, even modest blood pressure (BP) reductions to below this threshold regardless of antihypertensive class (1) should prevent MN and (2) lead to the healing of the already developed MN lesions. Both predicates were tested using BP radiotelemetry in the stroke-prone spo...
Source: Hypertension - September 10, 2014 Category: Cardiology Authors: Griffin, K. A., Polichnowski, A., Litbarg, N., Picken, M., Venkatachalam, M. A., Bidani, A. K. Tags: Animal models of human disease Kidney Source Type: research

Folic acid therapy reduces the risk of mortality associated with heavy proteinuria among hypertensive patients
Objective: We aimed to evaluate whether proteinuria and estimated glomerular filtration rate (eGFR) levels can modify the efficacy of folic acid therapy on the risk of all-cause mortality among hypertensive patients in the China Stroke Primary Prevention Trial, a randomized, double-blind, and controlled trial. Methods: A total of 20 702 hypertensive patients without a history of major cardiovascular diseases were randomly assigned to a double-blind daily treatment of a single tablet containing 10-mg enalapril and 0.8-mg folic acid (n = 10 348), or 10-mg enalapril alone (n = 10 354). All-cause mortality, a pr...
Source: Journal of Hypertension - April 26, 2017 Category: Cardiology Tags: ORIGINAL PAPERS: Kidney Source Type: research

Haemodynamic Responses to Selective Vagal Nerve Stimulation under Enalapril Medication in Rats
by Mortimer Gierthmuehlen, Thomas Stieglitz, Josef Zentner, Dennis T. T. Plachta Selective vagal nerve stimulation (sVNS) has been demonstrated to lower blood pressure (BP) in rats without causing major side effects. This method might be adapted for the treatment of therapy-resistant hypertension in patients. Converting enzyme inhibitors (CEIs) are among the first drugs that are administered for arterial hypertension and prominently reduce BP primarily by interacting with the renin-angiotensin system of the kidneys. Beyond the reduction of BP, CEI have a positive effect on the survival rate after myocardial infarction; th...
Source: PLoS One - January 14, 2016 Category: Biomedical Science Authors: Mortimer Gierthmuehlen et al. Source Type: research

Pattern of antihypertensive therapy among diabetic hyperten- sive patients in zewditu memorial hospital, addis ababa.
CONCLUSION: The pattern of antihypertensive drug therapy in our patients was consistent with the current treatment guidelines. However, the majority of diabetic-hypertensive patients did not reach target blood pressure. PMID: 27476227 [PubMed - in process]
Source: Ethiopian Medical Journal - August 3, 2016 Category: African Health Tags: Ethiop Med J Source Type: research

Folic acid supplementation and chronic kidney disease progression
In contrast to prior studies demonstrating no benefit or even increased harm from B vitamin supplementation in patients with chronic kidney disease, a large randomized trial from China recently demonstrated small but statistically significant reductions in the risk of first stroke and chronic kidney disease progression with the addition of folic acid to enalapril in adults with hypertension. Differences in the study population and study intervention may explain these discordant results.
Source: Kidney International - November 21, 2016 Category: Urology & Nephrology Authors: Christina M. Wyatt, J. David Spence Tags: Nephrology Digest Source Type: research

Effects of Folic Acid Therapy on the New-Onset Proteinuria in Chinese Hypertensive PatientsNovelty and Significance Clinical Trials
In conclusion, enalapril–folic acid therapy, compared with enalapril alone, significantly reduced the development of proteinuria in diabetic patients with hypertension.Clinical Trial Registration—URL: http://www.ClinicalTrials.gov. Unique identifier: NCT00794885.
Source: Hypertension - July 12, 2017 Category: Cardiology Authors: Youbao Li, Min Liang, Guobao Wang, Binyan Wang, Mingli He, Genfu Tang, Delu Yin, Xin Xu, Yong Huo, Yimin Cui, Fan Fan Hou, Xianhui Qin Tags: Clinical Studies, Diabetes, Type 1, Diet and Nutrition, Hypertension Original Articles Source Type: research

The modifying effect of the MTHFR genotype on the association between folic acid supplementation and pulse wave velocity: Findings from the CSPPT
ConclusionIn a subgroup of Chinese hypertensive patients who had received 5 ‐year antihypertensive therapy, increases in folate status were associated with higher reductions in PWV, and individuals with the CC genotype showed greatest PWV response to folic acid supplementation.
Source: Cardiovascular Therapeutics - November 20, 2018 Category: Cardiology Authors: Xin Yang, Minghua Zhang, Rensheng Song, Changfu Liu, Yong Huo, Geng Qian Tags: ORIGINAL RESEARCH ARTICLE Source Type: research

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