Advertisement

Journal of General Internal Medicine

, Volume 34, Issue 1, pp 15–16 | Cite as

Folic Acid-Containing Dietary Supplement Consumption and Risk of Cardiovascular Diseases in Rheumatoid Arthritis Patients: NHANES 1999–2014

  • Kalyani SonawaneEmail author
  • Jagpreet Chhatwal
  • Ashish A. Deshmukh
Concise Research Reports

INTRODUCTION

The risk of cardiovascular mortality among patients with rheumatoid arthritis (RA) is double than that of the general population.1 Elevated homocysteine level is considered to be one of the possible factors for increased cardiovascular mortality in RA patients.2 Homocysteine elevation is prevalent among RA patients,3 and a persistent increase in homocysteine level has been reported in patients treated with disease-modifying antirheumatic drugs (DMARDs).4 Folic acid (FA) supplementation can lower blood homocysteine levels by 25%5 and reduce the risk of cardiovascular diseases (CVDs) in the general population by nearly 4%.6 Benefits of long-term FA supplementation, if any, in RA patients are not known. The present study examines the association between consumption of FA-containing dietary supplement and the risk of CVDs in RA patients treated with DMARDs.

METHODS

We used data form the National Health and Nutrition Examination Survey (NHANES) 1999–2014, a complex, stratified,...

KEY WORDS

arthritis cardiovascular diseases prevention 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.

References

  1. 1.
    Avina-Zubieta JA, Choi HK, Sadatsafavi M, et al. Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum. 2008;59:1690–1697.CrossRefGoogle Scholar
  2. 2.
    Van Doornum S, McColl G, Wicks IP. Accelerated atherosclerosis: an extraarticular feature of rheumatoid arthritis? Arthritis Rheum. 2002;46:862–873.CrossRefGoogle Scholar
  3. 3.
    Roubenoff R, Dellaripa P, Nadeau MR, et al. Abnormal homocysteine metabolism in rheumatoid arthritis. Arthritis Rheum. 1997;40:718–722.CrossRefGoogle Scholar
  4. 4.
    Haagsma CJ, Blom HJ, van Riel PL, et al. Influence of sulphasalazine, methotrexate, and the combination of both on plasma homocysteine concentrations in patients with rheumatoid arthritis. Ann Rheum Dis. 1999;58:79–84.CrossRefGoogle Scholar
  5. 5.
    Lowering blood homocysteine with folic acid based supplements: meta-analysis of randomised trials. Homocysteine Lowering Trialists’ Collaboration. BMJ. 1998;316:894–898.Google Scholar
  6. 6.
    Li Y, Huang T, Zheng Y, et al. Folic acid supplementation and the risk of cardiovascular diseases: a meta-analysis of randomized controlled trials. J Am Heart Assoc. 2016;5.Google Scholar
  7. 7.
    CDC National Center for Health Statistics. National Health and Nutrition Examination Survey. 2011. http://www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm. Accessed 29 Nov 2016.

Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Kalyani Sonawane
    • 1
    Email author
  • Jagpreet Chhatwal
    • 2
  • Ashish A. Deshmukh
    • 1
  1. 1.Department of Management, Policy, and Community HealthThe University of Texas Health Science Center at HoustonHoustonUSA
  2. 2.Massachusetts General Hospital Institute for Technology AssessmentHarvard Medical SchoolBostonUSA

Personalised recommendations