title: Effect of folic acid supplementation on risk of new-onset diabetes in adults with hypertension in China: Findings from the China Stroke Primary Prevention Trial (CSPPT).
abstract: BACKGROUND
  The aim of the present post hoc analysis of the China Stroke Primary Prevention Trial (CSPPT) was to evaluate the effect of folic acid supplementation on the risk of new-onset diabetes in hypertensive adults in China.
  
  
  METHODS
  In all, 20 702 hypertensive adults with no history of stroke and/or myocardial infarction (MI) were randomly assigned to receive double-blind daily treatment with tablets containing either: (i) 10 mg enalapril and 0.8 mg folic acid (n = 10 348); or (ii) 10 mg enalapril alone (n = 10 354). New-onset diabetes was defined as either self-reported physician-diagnosed diabetes or the use of glucose-lowering drugs during the follow-up period of the CSPPT.
  
  
  RESULTS
  Over a median treatment duration of 4.5 years, new-onset diabetes occurred in 198 (2.0%) and 214 (2.1%) subjects in the enalapril-folic acid and enalapril groups, respectively (hazard ratio [HR] 0.92; 95% confidence interval [CI] 0.76-1.12). Similar results were observed when analyses were limited to subjects with baseline fasting glucose (FG) <7.0 mmol/L (HR 0.85; 95% CI 0.62-1.14). Furthermore, there was no significant group difference in: (i) the risk of new-onset FG ≥7.0 mmol/L (defined as FG <7.0 at baseline and ≥7.0 mmol/L at the last visit; relative risk [RR] 1.07; 95% CI 0.96-1.20); or (ii) the composite of new-onset diabetes or new-onset FG ≥7.0 mmol/L (RR = 1.06; 95% CI 0.95-1.19).
  
  
  CONCLUSIONS
  Among adults with hypertension with no history of stroke and/or MI in China, folic acid supplementation had no significant effect on the risk of new-onset diabetes.
authors.affiliation: National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University.
authors.forename: Xianhui
authors.initials: X
authors.lastname: Qin
authors.affiliation: Department of Cardiology, Peking University First Hospital.
authors.forename: Jianping
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Cardiology, Peking University First Hospital.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing.
authors.forename: Dafang
authors.initials: D
authors.lastname: Chen
authors.affiliation: National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University.
authors.forename: Binyan
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Neurology, First People's Hospital, Lianyungang.
authors.forename: Mingli
authors.initials: M
authors.lastname: He
authors.affiliation: Department of Neurology, First Affiliated Hospital of Anhui Medical University.
authors.forename: Jia
authors.initials: J
authors.lastname: Fu
authors.affiliation: Institute for Biomedicine.|School of Health Administration, Anhui Medical University, Hefei, China.
authors.forename: Genfu
authors.initials: G
authors.lastname: Tang
authors.affiliation: Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou.
authors.forename: Yefeng
authors.initials: Y
authors.lastname: Cai
authors.affiliation: Department of Neurology, First Affiliated Hospital of Anhui Medical University.
authors.forename: Xiuli
authors.initials: X
authors.lastname: Shi
authors.affiliation: National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University.
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.affiliation: National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University.
authors.forename: Fan Fan
authors.initials: FF
authors.lastname: Hou
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Xiaobin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Peking University First Hospital.
authors.forename: Yong
authors.initials: Y
authors.lastname: Huo
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D002681:China; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000208:ethnology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control; D014803:Vitamin B Complex / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D001786:Blood Glucose; D014803:Vitamin B Complex; D004656:Enalapril; D005492:Folic Acid
keywords: folic acid supplementation; hypertensive Chinese adults; new-onset diabetes; 中国成人高血压患者; 叶酸补充; 新发糖尿病