High blood pressure: spinach protects against stroke

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People with high blood pressure are more likely to have a stroke. The good news: Folic acid, known as a dietary supplement, protects against this.

Folic acid is essential for humans. Experts have long assumed that taking the vitamin can prevent stroke and other diseases of the heart and vascular system. Previous studies, however, did not allow a clear statement. Yong Huo from the Department of Cardiology at Peking University and his colleagues now wanted to clarify.

Antihypertensive versus folic acid plus antihypertensive

The team compared the risk of stroke and other cardiovascular diseases in high blood pressure patients when the antihypertensive agent enalapril (10 mg) was combined with folic acid (0.8 mg) and when only enalapril was administered (10 mg).

In total, over 20,700 hypertensive patients aged 45 to 75 years took part in the study. None of them have had a stroke, heart attack or anything like that before.

Risk reduced by 21 percent

The result: 3.4 percent of the participants who only received enalapril suffered a stroke in the course of the study. In the group with the folic acid-enalapril combination, however, it was only 2.7 percent. Accordingly, the enalapril folic acid group had a 21 percent lower risk of stroke compared to the comparison group. The additional folic acid was particularly effective in protecting against so-called ischemic strokes. The test subjects reduced their risk of this form of cerebral infarction, which is caused by blockage of the blood vessels, by a full 24 percent.

The combination of cardiovascular events (heart attack, stroke, and cardiovascular death) hit 3.1 percent of the enalapril folic acid group and 3.9 percent of the enalapril group, so their risk was 20 percent higher. On the other hand, there was no difference between the groups in terms of hemorrhagic stroke (caused by cerebral haemorrhage), myocardial infarction and mortality.

Folic acid is useful for everyone

Folic acid is important for the body because it influences the metabolism in several places: Among other things, it lowers the homocysteine ​​level - this amino acid can otherwise attack the blood vessels, among other things. Ideally, humans take in enough of it through food, but this is often not the case.

The German Nutrition Society (DGE) recommends a daily dose of 0.3 milligrams for adolescents and adults. Children need less, while pregnant and breastfeeding women need more. Green leafy vegetables such as spinach, tomatoes, legumes, innards and eggs are particularly rich in folic acid. Please note, however: Too much folic acid - over a milligram - is also not good and harms the body, warns the Federal Institute for Risk Assessment.

In China, where the study took place, there is relatively little folic acid in the diet. Nevertheless, the scientists believe that their results can also be transferred to countries where a large part of the folic acid requirement is met by food. There, too, people with high blood pressure would benefit from an additional intake of folic acid. Especially those who have only low or normal values. The experts are convinced: the study could be of great importance for stroke prevention worldwide.

Circulatory disorder in the brain

Stroke is on the list of the ten leading causes of death. There are several risk factors: diabetes, bad cholesterol levels, nicotine or a bad diet - but above all high blood pressure.

The cerebral infarction is triggered by a sudden circulatory disorder in the brain. The affected nerve cells are no longer adequately supplied with oxygen and nutrients and die. In 80 percent of the cases, people have an ischemic heart attack.The hemorrhagic stroke, on the other hand, only occurs in 20 percent.

Sources:

Huo Yong et al .: Efficacy of Folic Acid Therapy in Primary Prevention of Stroke Among Adults With Hypertension in China. The CSPPT Randomized Clinical Trial. The Journal of the American Medical Association. doi: 10.1001 / jama.2015.2274

Stampfer Meier & Willett Walter: Folate Supplements for Stroke Prevention. Targeted Trial Trumps the Rest. The Journal of the American Medical Association. doi: 10.1001 / jama.2015.1961

Federal Institute for Risk Assessment: www.bfr.bund.de (accessed on March 30, 2015)

German Nutrition Society: www.dge.de (accessed on March 30, 2015)

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