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IV
HOMOCYSTEINE LOWERING IN CHRONIC STABLE VASCULAR DISEASE. THE HEART OUTCOMES PREVENTION EVALUATION-2 TRIAL
E Lonn, S Yusuf
The HOPE-2 trial is the largest homocysteine lowering trial world-wide completed to date. Combined daily administration of folic acid 2.5 mg, vitamin B6 50 mg and vitamin B12 1 mg for five years had no beneficial effects on major vascular events in a high-risk population with vascular disease. The results of the trial do not support preventive treatment with folic acid and B vitamin supplements.
Hamilton, Ontario
Homocysteine was proposed as a modifiable CV risk factor. B vitamins lower homocysteine concentrations. 5522 patients 55 years or older with CVD were randomly assigned to daily treatment with combined folic acid 2.5 mg, vitamin B6 50 mg and vitamin B12 1 mg or placebo for five years. 18.8% of patients in the active treatment group and 19.8% in the placebo group had a primary outcome event (CV death, MI or stroke) (P=0.41). There were no significant differences CV deaths, MI or any of the secondary outcomes. There were fewer strokes, but more unstable angina events in the active treatment group.