(Circulation. 2001;103:2674.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Low Dietary Folate Intake Is Associated With an Excess Incidence of Acute Coronary Events
The Kuopio Ischemic Heart Disease Risk Factor Study
From the Research Institute of Public Health (S.V., T.R., J.V., T.A.L., J.T.S.), University of Kuopio, Kuopio, and the Inner Savo Health Centre (J.T.S.), Suonenjoki, Finland.
Background—Although several prospective studies have shown that low folate intake and low circulating folate are associated with increased risk of coronary heart disease (CHD), the findings are inconsistent.
Methods and Results—We studied the associations of dietary intake of folate, vitamin B6, and vitamin B12 with the risk of acute coronary events in a prospective cohort study of 1980 Finnish men 42 to 60 years old examined in 1984 to 1989 in the Kuopio Ischemic Heart Disease Risk Factor Study. Nutrient intakes were assessed by 4-day food record. During an average follow-up time of 10 years, 199 acute coronary events occurred. In a Cox proportional hazards model adjusted for 21 conventional and nutritional CHD risk factors, men in the highest fifth of folate intake had a relative risk of acute coronary events of 0.45 (95% CI 0.25 to 0.81, P=0.008) compared with men in the lowest fifth. This association was stronger in nonsmokers and light alcohol users than in smokers and alcohol users. A high dietary intake of vitamin B6 had no significant association and that of vitamin B12 a weak association with a reduced risk of acute coronary events.
Conclusions—The present work in CHD-free middle-aged men is the first prospective cohort study to observe a significant inverse association between quantitatively assessed moderate-to-high folate intakes and incidence of acute coronary events in men. Our findings provide further support in favor of a role of folate in the promotion of good cardiovascular health.
Key Words: cardiovascular diseases • diet • epidemiology • follow-up studies • nutrition
This article has been cited by other articles:
 |
|
 |
|
  A. T. Toriola, S. Kurl, J. A. Laukkanen, and J. Kauhanen Does binge drinking increase the risk of lung cancer: results from the Findrink study Eur J Public Health, August 1, 2009; 19(4): 389 - 393. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Ishihara, H. Iso, M. Inoue, M. Iwasaki, K. Okada, Y. Kita, Y. Kokubo, A. Okayama, S. Tsugane, and for the JPHC Study Group Intake of Folate, Vitamin B6 and Vitamin B12 and the Risk of CHD: The Japan Public Health Center-Based Prospective Study Cohort I J. Am. Coll. Nutr., February 1, 2008; 27(1): 127 - 136. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Gori, F. Sofi, A. M. Corsi, A. Gazzini, I. Sestini, F. Lauretani, S. Bandinelli, G. F. Gensini, L. Ferrucci, and R. Abbate Predictors of Vitamin B6 and Folate Concentrations in Older Persons: The InCHIANTI Study Clin. Chem., July 1, 2006; 52(7): 1318 - 1324. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. H. Bonaa, I. Njolstad, P. M. Ueland, H. Schirmer, A. Tverdal, T. Steigen, H. Wang, J. E. Nordrehaug, E. Arnesen, K. Rasmussen, et al. Homocysteine Lowering and Cardiovascular Events after Acute Myocardial Infarction N. Engl. J. Med., April 13, 2006; 354(15): 1578 - 1588. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. J Stover Influence of human genetic variation on nutritional requirements Am. J. Clinical Nutrition, February 1, 2006; 83(2): 436S - 442S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Weikert, K. Hoffmann, J. Dierkes, B.-C. Zyriax, K. Klipstein-Grobusch, M. B. Schulze, R. Jung, E. Windler, and H. Boeing A Homocysteine Metabolism-Related Dietary Pattern and the Risk of Coronary Heart Disease in Two Independent German Study Populations J. Nutr., August 1, 2005; 135(8): 1981 - 1988. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. K. Virtanen, S. Voutilainen, T. H. Rissanen, J. Mursu, T.-P. Tuomainen, M. J. Korhonen, V.-P. Valkonen, K. Seppanen, J. A. Laukkanen, and J. T. Salonen Mercury, Fish Oils, and Risk of Acute Coronary Events and Cardiovascular Disease, Coronary Heart Disease, and All-Cause Mortality in Men in Eastern Finland Arterioscler Thromb Vasc Biol, January 1, 2005; 25(1): 228 - 233. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Tolmunen, J. Hintikka, S. Voutilainen, A. Ruusunen, G. Alfthan, K. Nyyssonen, H. Viinamaki, G. A Kaplan, and J. T Salonen Association between depressive symptoms and serum concentrations of homocysteine in men: a population study Am. J. Clinical Nutrition, December 1, 2004; 80(6): 1574 - 1578. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Laukkanen, D. E. Laaksonen, L. Niskanen, E. Pukkala, A. Hakkarainen, and J. T. Salonen Metabolic Syndrome and the Risk of Prostate Cancer in Finnish Men: A Population-Based Study Cancer Epidemiol. Biomarkers Prev., October 1, 2004; 13(10): 1646 - 1650. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Vrentzos, J. A. Papadakis, N. Malliaraki, E. A. Zacharis, K. Katsogridakis, A. N. Margioris, P. E. Vardas, and E. S. Ganotakis Association of Serum Total Homocysteine with the Extent of Ischemic Heart Disease in a Mediterranean Cohort Angiology, September 1, 2004; 55(5): 517 - 524. [Abstract] [PDF]
|
|
|
|
|
|
C. Holmquist, S. Larsson, A. Wolk, and U. de Faire Multivitamin Supplements Are Inversely Associated with Risk of Myocardial Infarction in Men and Women--Stockholm Heart Epidemiology Program (SHEEP) J. Nutr., August 1, 2003; 133(8): 2650 - 2654. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Samman, G. Sivarajah, J. C. Man, Z. I. Ahmad, P. Petocz, and I. D. Caterson A Mixed Fruit and Vegetable Concentrate Increases Plasma Antioxidant Vitamins and Folate and Lowers Plasma Homocysteine in Men J. Nutr., July 1, 2003; 133(7): 2188 - 2193. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. K. Kim, J. M. Ordovas, J. Selhub, and H. Campos B Vitamins and Plasma Homocysteine Concentrations in an Urban and Rural Area of Costa Rica J. Am. Coll. Nutr., June 1, 2003; 22(3): 224 - 231. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Girelli, N. Martinelli, F. Pizzolo, S. Friso, O. Olivieri, C. Stranieri, E. Trabetti, G. Faccini, E. Tinazzi, P. F. Pignatti, et al. The Interaction between MTHFR 677 C->T Genotype and Folate Status Is a Determinant of Coronary Atherosclerosis Risk J. Nutr., May 1, 2003; 133(5): 1281 - 1285. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Zeisel, M.-H. Mar, J. C. Howe, and J. M. Holden Concentrations of Choline-Containing Compounds and Betaine in Common Foods J. Nutr., May 1, 2003; 133(5): 1302 - 1307. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Hung, J. P Beilby, M. W Knuiman, and M. Divitini Folate and vitamin B-12 and risk of fatal cardiovascular disease: cohort study from Busselton, Western Australia BMJ, January 18, 2003; 326(7381): 131 - 131. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. H. Rissanen, S. Voutilainen, J. K. Virtanen, B. Venho, M. Vanharanta, J. Mursu, and J. T. Salonen Low Intake of Fruits, Berries and Vegetables Is Associated with Excess Mortality in Men: the Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study J. Nutr., January 1, 2003; 133(1): 199 - 204. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. B. Hu and W. C. Willett Optimal Diets for Prevention of Coronary Heart Disease JAMA, November 27, 2002; 288(20): 2569 - 2578. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Klerk, P. Verhoef, R. Clarke, H. J. Blom, F. J. Kok, E. G. Schouten, and and the MTHFR Studies Collaboration Group MTHFR 677C->T Polymorphism and Risk of Coronary Heart Disease: A Meta-analysis JAMA, October 23, 2002; 288(16): 2023 - 2031. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.C. Verhaar, E. Stroes, and T.J. Rabelink Folates and Cardiovascular Disease Arterioscler Thromb Vasc Biol, January 1, 2002; 22(1): 6 - 13. [Abstract] [Full Text] [PDF]
|
|