According to a report in The Journal of the American Medical Association. Coronary heart disease is reduced by lowering plasma homocystine levels with a diet supplement of folic acid alone or in combination with cyanocobalamin.
Dr.Tice from the University of California at San Francisco and colleagues used the Coronary Heart Disease Policy Model to assess the cost effectiveness of lowering levels of homocystine through grains fortified with folic acid and with cyanocobalamin and folic acid among participants in the third National Health and Nutrition Examination Survey.
Their model predicted that grains fortified with folic acid could reduce myocardial infarction by 13% in men and 8% in women, with comparable reductions in death from CHD. "Using our most conservative assumptions, the estimated reductions in annual CHD mortality rates were 1% to 3%," the researchers report.
In addition to consuming fortified grains, if all patients with CHD received 1 mg of folic acid plus 0.5 mg of cyanocobalamin per day, the model projected that there would be approximately 310,000 fewer deaths and lower CHD-related costs over 10 years, compared with consuming folic-acid-fortified grains alone.
Over the same 10-year period, the model also predicted that for men 45 years of age or older without CHD, folic acid and cyanocobalamin supplementation given in addition to fortified grains would save more than 300,000 quality adjusted life-years. In addition, for women 55 years of age and older without CHD, the same strategy would result in 140,000 quality adjusted life-years saved, Dr.Tice's group calculated.