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B Vitamins Improve Angioplasty Outcome
By Matt Brignall, ND

Healthnotes Newswire A simple, inexpensive B-vitamin supplement improves the results of a common procedure performed in heart patients known as angioplasty, according to an article published last week in the New England Journal of Medicine.1 Angioplasty is a mechanical procedure used to open clogged arteries, usually those of the heart. Traditionally, the major drawback of this procedure has been that the arteries, once opened, often rapidly narrow again.

In this new double-blind trial, patients who had undergone successful angioplasty received treatment for six months with either a mixture of B vitamins (1 mg of folic acid, 400 mcg of vitamin B12, and 10 mg of vitamin B6 per day) or placebo. After six months, only half as much renarrowing of the arteries was seen in participants taking the B vitamins compared with those taking placebo. Also, less than half as many participants taking the B vitamins went on to require coronary bypass surgery, compared with placebo-treated individuals.

The beneficial effect of B vitamins may be due in large part to their ability to reduce the levels of a toxic compound called homocysteine. This compound, which is a breakdown product of protein, tends to build up in the blood stream of individuals with low dietary intake of B vitamins. Although a relationship between blood homocysteine levels and heart disease risk was suggested as early as 1969,2 such a relationship was not accepted among scientists until about five years ago. Today, most doctors agree that an elevated blood level of homocysteine is a risk factor for hardening of the arteries (atherosclerosis), coronary heart disease, and stroke.3 Previous clinical trials have established that supplementation with folic acid,4 vitamin B12,5 and vitamin B6 can each reduce elevated homocysteine levels.6

Although serum homocysteine has not become a standard screening test for cardiovascular disease prevention, it can be ordered through most medical laboratories. Prior research suggests that a blood homocysteine level below 9 micromol per liter is optimal for reducing heart disease risk.

While the evidence is not yet conclusive, many doctors believe that screening for high homocysteine levels among healthy individuals, and using B-vitamin supplements when necessary, may help prevent heart disease. In one recent study, supplementation with vitamin B6 and folic acid for two years reduced the development of early atherosclerosis by 60% in the healthy siblings of heart patients.7

References
1. Schnyder G, Roffi M, Pin R, et al. Decreased rate of coronary restenosis after lowering of plasma homocysteine levels. N Engl J Med 2001;345:1593.
2. McCully KS. Vascular pathology of homocysteinemia: implications for the pathogenesis of arteriosclerosis. Am J Pathol 1969;56:11128.
3. Christen WG, Ajani UA, Glynn RJ, Hennekens CH. Blood levels of homocysteine and increased risks of cardiovascular disease. Arch Intern Med 2000;160:42234.
4. Wald DS, Bishop L, Wald NJ, et al. Randomized trial of folic acid supplementation and serum homocysteine levels. Arch Intern Med 2001;161:695700.
5. Bronstrup A, Hages M, Prinz-Langenohl R, Pietrzik K. Effects of folic acid and combinations of folic acid and vitamin B-12 on plasma homocysteine concentrations in healthy, young women. Am J Clin Nutr 1998;68:110410.
6. McKinley MC, McNulty H, McPartlin J, et al. Low-dose vitamin B-6 effectively lowers fasting plasma homocysteine in healthy elderly persons who are folate and riboflavin replete. Am J Clin Nutr 2001;73:75964.
7. Vermeulen EGJ, Stehouwer CDA, Twisk JWR, et al. Effect of homocysteine-lowering treatment with folic acid plus vitamin B6 on progression of subclinical atherosclerosis: a randomised, placebo-controlled trial. Lancet 2000;355:51722.

Matt Brignall, ND, is in practice at the Seattle Cancer Treatment and Wellness Center and at the Evergreen Integrative Medicine Clinic in Kirkland, WA. He specializes in integrative treatment of cancer. He is a contributor to Healthnotes and Healthnotes Newswire.




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