Abstract
Stroke remains one of the most common causes of death, especially for older people. with hypertension. In addition to known risk factors leading to stroke, more and more attention is being paid to the increased concentration of homocysteine in blood serum. Several studies show that patients who have had a stroke are characterized by a higher concentration of homocysteine in the blood serum than people of the same age and comparable blood pressure with normal concentration of this compound in the blood serum. It has long been known that the administration of folic acid and other B vitamins significantly reduces serum homocysteine. The first large randomized studies (e.g. NORVIT) did not show that increased B vitamin supply reduced cardiovascular disease. Later studies indicate, however, that supplementation with these vitamins reduces the number of strokes, but does not change the risk of coronary heart disease. A number of meta-analyzes clearly indicate that oral administration of folic acid by at least 10% -20% reduces the incidence of strokes in patients with hypertension in both primary and secondary prevention, especially in countries where folic acid is not mandatory in food products. In patients with hypertension and elevated folic acid levels and not treated with aspirin (e.g. primary prevention), the effectiveness of folic acid supplementation in reducing stroke is even higher.
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