Endothelial function in post-menopausal women: effect of folic acid supplementation.
BACKGROUND
Higher than normal homocysteine levels are associated with an increased incidence of adverse cardiovascular events in post-menopausal women, perhaps via hyperhomocysteinaemia-induced vascular endothelial damage. Because folic acid supplementation reduces homocysteine levels, we attempted to evaluate whether folic acid supplementation may affect endothelial function in post-menopausal women.


METHODS
Brachial artery flow-mediated dilatation (endothelium-dependent) and nitroglycerin-induced dilatation (endothelium-independent) before and after a methionine load were analysed in 15 healthy post-menopausal women. Plasma levels of folate, homocysteine, glucose, insulin and lipids were measured, as was blood pressure. All studies were repeated after 1 month supplementation with 7.5 mg/day of folic acid.


RESULTS
After folate, endothelial function rose 37% over pre-folic acid supplementation value (P < 0.001), and flow-mediated dilation before folic acid was reduced by 62% subsequent to methionine loading (P < 0.0001); this reduction was still present after folic acid, but was only 19% (P < 0.001). Nitroglycerin-induced dilatation did not change in response to methionine loading before or after folic acid supplementation. Among the other cardiovascular risk factors studied, only high-density lipoprotein (HDL)-cholesterol and low-density lipoprotein (LDL)-cholesterol showed significant changes after folic acid supplementation, with a 6% increase (P < 0.03) and a 9% decrease (P < 0.03) respectively.


CONCLUSIONS
Although preliminary, these results indicate that folic acid supplementation may improve endothelial function and lipid profile in post-menopausal women, thus contributing to reduce their cardiovascular risk.
Paradisi
Giancarlo
G
Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy. giancarlo.paradisi@tin.it
Cucinelli
Francesco
F
Mele
Maria Cristina
MC
Barini
Angela
A
Lanzone
Antonio
A
Caruso
Alessandro
A
D001916:Brachial Artery / Q000187:drug effects* / Q000502:physiology; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000502:physiology*; D005260:Female; D005492:Folic Acid / Q000494:pharmacology*; D006801:Humans; D008715:Methionine / Q000494:pharmacology*; D008875:Middle Aged; D005996:Nitroglycerin / Q000494:pharmacology*; D017698:Postmenopause / Q000097:blood / Q000502:physiology*; D014664:Vasodilation / Q000187:drug effects*
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D005492:Folic Acid; D008715:Methionine; D005996:Nitroglycerin