title: Randomized clinical trial of folate supplementation in patients with peripheral arterial disease.
abstract: BACKGROUND
  The aim was to determine whether folate supplementation improved arterial function in patients with peripheral arterial disease (PAD).
  
  
  METHODS
  Individuals with PAD were randomly assigned to receive 400 microg folic acid (45 patients) or 5-methyltetrahydrofolate (5-MTHF) (48) daily, or placebo (40) for 16 weeks. Primary endpoints were changes in plasma total homocysteine (tHcy), ankle : brachial pressure index (ABPI) and pulse wave velocity (PWV). Secondary outcomes were changes in plasma inflammatory markers.
  
  
  RESULTS
  Plasma tHcy was significantly reduced in folic acid and 5-MTHF groups compared with controls: median difference: - 2.12 (95 per cent confidence interval - 3.70 to - 0.75) micromol/l (P = 0.002) and - 2.07 (-3.48 to - 0.54) micromol/l (P = 0.007) respectively. ABPI improved significantly: median difference 0.07 (0.04 to 0.11) (P < 0.001) and 0.05 (0.01 to 0.10) (P = 0.009) respectively. Brachial-knee PWV (bk-PWV) decreased significantly in individuals receiving 5-MTHF and tended to be reduced in those taking folic acid compared with controls: median difference: - 1.10 (-2.20 to - 0.20) m/s (P = 0.011) and - 0.90 (-2.10 to 0.00) m/s (P = 0.051) respectively. Plasma levels of inflammatory markers were not affected.
  
  
  CONCLUSIONS
  Folate administration reduced plasma homocysteine, and slightly improved ABPI and bk-PWV.
authors: Vascular Unit, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK. nkh950@yahoo.com
authors: N
authors: N
authors: Khandanpour
authors: M P
authors: MP
authors: Armon
authors: B
authors: B
authors: Jennings
authors: P M
authors: PM
authors: Finglas
authors: G
authors: G
authors: Willis
authors: A
authors: A
authors: Clark
authors: F J
authors: FJ
authors: Meyer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D001783:Blood Flow Velocity / Q000187:drug effects; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006710:Homocysteine / Q000378:metabolism; D006801:Humans; D007383:Intermittent Claudication / Q000097:blood / Q000178:diet therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013763:Tetrahydrofolates / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D013763:Tetrahydrofolates; D006710:Homocysteine; D005492:Folic Acid; C005984:5-methyltetrahydrofolate