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Effect of Folic Acid and B Vitamins on Cardiovascular Disease in Women—Reply
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In Reply: We agree with Dr Ntaios and colleagues that null results from published randomized trials of folic acid and B vitamins do not rule out the possibility that long-term dietary folic acid fortification may have a beneficial effect on cardiovascular risk. However, dietary fortification has been broadly implemented in a nonrandomized fashion. It will therefore be difficult to disentangle the specific effects of fortification from other changes and improvements in risk factor profiles and preventive therapies that may also have taken place in these populations over the same time period and that may influence cardiovascular risk.
Also, as Dr Akilzhanova and colleagues point out, the results in our fortified study population of health professionals who were at low risk for folate deficiency may not apply to populations with a greater prevalence of folate deficiency. We agree that dietary fortification with folic acid should be pursued in such populations to . . . [Full Text of this Article]
Christine M. Albert, MD, MPH
calbert@partners.org
Nancy R. Cook, ScD;
JoAnn E. Manson, MD, DrPH
Brigham and Women's Hospital
Boston, Massachusetts
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