| Title | Effect of Smoking and Folate Levels on the Efficacy of Folic Acid Therapy in Prevention of Stroke in Hypertensive Men |
| Authors | Zhou, Ziyi Li, Jianping Yu, Yaren Li, Youbao Zhang, Yan Liu, Lishun Song, Yun Zhao, Min Wang, Yu Tang, Genfu He, Mingli Xu, Xiping Cai, Yefeng Dong, Qiang Yin, Delu Huang, Xiao Cheng, Xiaoshu Wang, Binyan Hou, Fan Fan Wang, Xiaobin Qin, Xianhui Huo, Yong |
| Affiliation | China Agr Univ, Beijing Adv Innovat Ctr Food Nutr & Human Hlth, Coll Food Sci & Nutr Engn, Beijing, Peoples R China. Anhui Med Univ, Inst Biomed, Hefei, Anhui, Peoples R China. Peking Univ, Dept Cardiol, Hosp 1, 8 Xishiku St, Beijing 100034, Peoples R China. Southern Med Univ, Nanfang Hosp, Renal Div, State Key Lab Organ Failure Res,Natl Clin Res Ctr, 1838 N Guangzhou Ave, Guangzhou 510515, Guangdong, Peoples R China. Anhui Univ, Sch Hlth Adm, Hefei, Anhui, Peoples R China. First Peoples Hosp, Dept Neurol, Lianyungang, Peoples R China. First Peoples Hosp, Dept Cardiol, Lianyungang, Peoples R China. Guangdong Prov Hosp Chinese Med, Dept Neurol, Guangzhou, Guangdong, Peoples R China. Fudan Univ, Huashan Hosp, Dept Neurol, Shanghai, Peoples R China. Nanchang Univ, Dept Cardiovasc Med, Affiliated Hosp 2, Nanchang, Jiangxi, Peoples R China. Johns Hopkins Univ, Dept Populat Family & Reprod Hlth, Bloomberg Sch Publ Hlth, Baltimore, MD USA. Peking Univ, Dept Cardiol, Hosp 1, 8 Xishiku St, Beijing 100034, Peoples R China. Qin, XH (reprint author), Southern Med Univ, Nanfang Hosp, Renal Div, State Key Lab Organ Failure Res,Natl Clin Res Ctr, 1838 N Guangzhou Ave, Guangzhou 510515, Guangdong, Peoples R China. |
| Keywords | enalapril folic acid men risk smoking CARDIOVASCULAR-DISEASE MORTALITY PROSPECTIVE COHORT TOBACCO SMOKING SERUM FOLATE YOUNG-WOMEN ALL-CAUSE ADULTS METAANALYSIS EVENTS CHINA |
| Issue Date | 2018 |
| Publisher | STROKE |
| Citation | STROKE. 2018, 49(1), 114-+. |
| Abstract | Background and Purpose-We aimed to examine whether the efficacy of folic acid therapy in the primary prevention of stroke is jointly affected by smoking status and baseline folate levels in a male population in a post hoc analysis of the CSPPT (China Stroke Primary Prevention Trial). Methods-Eligible participants of the CSPPT were randomly assigned to a double-blind daily treatment of a combined enalapril 10-mg and folic acid 0.8-mg tablet or an enalapril 10-mg tablet alone. In total, 8384 male participants of the CSPPT were included in the current analyses. The primary outcome was first stroke. Results-The median treatment duration was 4.5 years. In the enalapril-alone group, the first stroke risk varied by baseline folate levels and smoking status (never versus ever). Specifically, there was an inverse association between folate levels and first stroke in never smokers (P for linear trend=0.043). However, no such association was found in ever smokers. A test for interaction between baseline folate levels and smoking status on first stroke was significant (P=0.045). In the total sample, folic acid therapy significantly reduced the risk of first stroke in never smokers with folate deficiency (hazard risk, 0.36; 95% confidence interval, 0.16-0.83) and in ever smokers with normal folate levels (hazard risk, 0.69; 95% confidence interval, 0.48-0.99). Conclusions-Baseline folate levels and smoking status can interactively affect the risk of first stroke. Our data suggest that compared with never smokers, ever smokers may require a higher dosage of folic acid to achieve a greater beneficial effect on stroke. Our findings need to be confirmed by future randomized trials. |
| URI | http://hdl.handle.net/20.500.11897/500159 |
| ISSN | 0039-2499 |
| DOI | 10.1161/STROKEAHA.117.018273 |
| Indexed | SCI(E) PubMed Medline |
| Appears in Collections: | 第一医院 |
