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首页> 外文期刊>Frontiers in Pharmacology >A Meta-Analysis of Folic Acid in Combination with Anti-Hypertension Drugs in Patients with Hypertension and Hyperhomocysteinemia
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A Meta-Analysis of Folic Acid in Combination with Anti-Hypertension Drugs in Patients with Hypertension and Hyperhomocysteinemia

机译：高血压高同型半胱氨酸血症患者叶酸与抗高血压药合用的Meta分析

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Folic acid is generally used to lower homocysteine concentrations and prevent stroke and cardiovascular disease (CVD) at present. However, the efficacy of therapies that lower homocysteine concentrations in reducing the risk of CVD and stroke remains controversial. Our objective was to do a meta-analysis of relevant randomized controlled trials (RCTs) to evaluate the efficacy of folic acid supplementation among patients with hypertension and Hyperhomocysteinemia (HT/HHcy). We included RCTs examining the effects of folic acid plus antihypertensive therapy compared to antihypertensive alone. Weighted Mean Difference (WMD) and Relative risk (RR) were used as a measure of the effect of folic acid on the outcome measures with a random effect model. Sixty-five studies including 7887 patients met all inclusion criteria. Among them, 49 trials reported significant effect of combination therapy for reducing SBP (systolic Blood Pressure) and DBP (Diastolic Blood Pressure) levels compared with antihypertensive alone (WMD = ?7.85, WMD = ?6.77, respectively). Meanwhile, folic acid supplementation apparently reduced the level of total homocysteine (WMD = 5.5). In addition, folic acid supplementation obviously reduced the risk of cardiovascular and cerebrovascular events (CVCE) by 12.9% compared with control groups. In terms of the stratified analyses, a bigger beneficial effect was seen in those RCTs with treatment duration of more than 12 weeks, a decrease in the concentration of total homocysteine of more than 25%, with folic acid fortification. Our findings indicated that folic acid supplementation was effective in the primary prevention of CVCE among HT/HHcy patients, as well as reducing the blood pressure and total homocysteine levels.
机译：目前，叶酸通常用于降低高半胱氨酸浓度并预防中风和心血管疾病（CVD）。但是，降低同型半胱氨酸浓度的疗法在降低CVD和中风风险中的功效仍存在争议。我们的目标是对相关的随机对照试验（RCT）进行荟萃分析，以评估补充叶酸对高血压和高同型半胱氨酸血症（HT / HHcy）患者的疗效。我们纳入了RCT，研究了叶酸加抗高血压治疗与单纯抗高血压治疗相比的效果。加权均数差（WMD）和相对风险（RR）用作叶酸对随机效应模型对结局指标的影响。包括7887例患者在内的65项研究符合所有纳入标准。其中，有49项试验报道了与单独使用降压药相比，联合疗法对降低SBP（收缩压）和DBP（舒张压）的效果显着（分别为WMD = 7.85，WMD = 6.77）。同时，补充叶酸显然降低了总同型半胱氨酸的水平（WMD = 5.5）。此外，与对照组相比，补充叶酸可将心血管和脑血管事件（CVCE）的风险明显降低12.9％。就分层分析而言，在治疗时间超过12周的那些RCT中看到了更大的有益效果，叶酸强化后总同型半胱氨酸的浓度降低了25％以上。我们的研究结果表明，叶酸补充剂可有效预防HT / HHcy患者的CVCE，并降低血压和总同型半胱氨酸水平。

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