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To the Editor: Dr Albert and colleagues¹ studied the effect of folic acid and B vitamins on cardiovascular disease. In their study, more than one-fifth of the participants had diabetes mellitus and therefore may have been using oral hypoglycemic agents.

The authors did not describe the use of any diabetes medications in the article. Rosiglitazone, a widely used antidiabetic agent introduced in 1999, could have been prescribed; it is associated with higher risk of myocardial ischemic events.² Failure to consider such a possibility could have led to biased measure of the incidence of cardiovascular disease in the study population.

Financial Disclosures: None reported.

Weekitt Kittisupamongkol, MD
weekitti@gmail.com
Hua Chiew Hospital
Bangkok, Thailand

1. Albert CM, Cook NR, Gaziano JM; et al. Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial. JAMA. 2008;299(17):2027-2036. FREE FULL TEXT 2. Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes [published correction in N Engl J Med. 2007;357(1):100]. N Engl J Med. 2007;356(24):2457-2471. FREE FULL TEXT

Letters Section Editor: Robert M.Golub, MD, Senior Editor.

JAMA. 2008;300(12):1410.

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