EFFECT OF FOLIC ACID SUPPLEMENTATION IN PATIENTS WITH CHRONIC HEART FAILURE: PP.1.13

Abstract

Background: Patients with chronic heart failure (CHF) are characterized by endothelial dysfunction, partly due to increased oxidative stress. Since folic acid exerts potential antioxidant activity, the present study was designed to evaluate the impact of folic acid supplementation on endothelial function, as well as on markers of chronic inflammation and oxidative-stress. Methods and Results: 20 patients with CHF were included in this randomized, double blind, placebo-controlled study to receive folic acid (5 mg/day) or placebo for 1 month, on top of standard optimal therapy. Despite a significant increase in plasma folate levels (from 6.9 ± 3.2 to 163.2 ± 147.7 ng/ml, p < 0.01) and a significant reduction in homocystein plasma concentration (from 14.8 ± 3.5 to 12.0 ± 2.0 mmol/L p = 0.011) in the folate-group, endothelial function, as assessed non-invasively by flow mediated vasodilatation, was not significantly affected (from 3.8 ± 1.7% to 4.1 ± 2.1%, p = 0.64). Oxidative stress and inflammation parameters did not change significantly after folate substitution. However, 4 weeks of treatment with 5 mg folic acid significantly decreased diastolic blood pressure (DBP) as compared to baseline from 76.1 ± 12.2 to 69.5 ± 7.2mmHg; p = 0.03). A not-significant decrease in systolic blood pressure (SBP) was also observed (from 115 ± 10.5 to 111 ± 12.8mmHg; p = 0.06). There was no change in blood pressure after placebo (SBP from 113.8 ± 8.9 to 116 ± 5.1mmHg, p = 0.36 DBP from 68.9 ± 7.2 to 71.0 ± 6.9mmHg p = 0.13). Conclusion: Chronic treatment with folic acid (5 mg/day) over one month did not improve endothelial function and oxidative as well as inflammatory parameters in patients with CHF. However a significant reduction in arterial blood pressure has been observed.