Hypertension is a serious health condition that may eventually lead to stroke. Patients suffering from hypertension and low platelet count benefitted immensely when they were administered a combination of daily pills containing both enalapril and folic acid.
The chances of suffering from stroke diminished significantly in these patients as compared to those patients who simply took enapril on daily basis. These findings were published in the Journal of the American College of Cardiology. Most patients succumb to a stroke and die ultimately. All over the world, stroke is considered to be the second leading cause of death; however, stroke is the number one cause of death in China.
In more than 77 percent of cases, patients die of stroke in just one shot.
Consider an earlier report published in China Stroke Primary Prevention Trial (CSPPT). These researchers reported that folic acid was immensely useful for preventing stroke in patients with chronic hypertension. In fact, stroke could be prevented in as many as 21 percent patients with hypertension. In these cases, the total homocysteine levels would be lowered tremendously with folic acid treatment.
An elevation in hypertension is also risk factor for cardiovascular diseases. The study published in the Journal of American College of Cardiology is one of its kind in the sense that it examined the effect of folic acid on both elevated levels of homocysteine and platelet, which are significant precursors of cardiovascular disease and first incidence of stroke.
Researchers conducted a survey on 10.789 subjects that participated in CSPPT. These subjects were men and women in the age group of 45 to 75 years; these patients had a history of hypertension and they were on medication to control their condition. In this study, researchers did not include patients who had suffered a stroke previously; moreover, they also excluded patients who had a significant cardiovascular disease. These researchers were divided into two groups randomly.
The first group consisted of 5,408 patients who were administered a dose of 10 mg enalapril and 0.8 folic acid on a daily basis. The second group consisted of 5,381 patients who had received only a single dose of enalapril. Among the total number of excluded subjects, there were 371 patients who had survived their first stroke attack within an average age of 4.2 years.
Interestingly, there were 210 patients who suffered a stroke despite being on enalapril medication for several years; however, there were 161 patients who suffered from first time stroke despite receiving enalapril and folic acid treatment. The risk of suffering from first-time stroke increases under following conditions: a low level of platelet count and elevated levels of homocysteine.
These findings must be further validated in future clinical trials. In that case, it would be easier to identify hypertensive patients prone to stroke. We can simply measure their platelet count and homocysteine levels to rule out such uneventful, drastic possibilities. Folic acid is an essential nutrient for all individuals; the recommended daily amount (RDA) of folic acid is prescribed by the Food and Drug Administration (FDA). Folic acid is a simple and safe way of preventing the possibility of stroke in hypertensive patients.
In patients with low platelet count and high levels of homocysteine, the possibility of first-time stroke decreased dramatically from 5.6 percent to 1.8 percent. Thus, folic acid administration could reduce the risk of stroke in these patients by about 73 percent. Nevertheless, folic acid did not have any effect on hypertensive patients with low homocysteine level and high platelet count.
The public health implications would be tremendous if these results are confirmed by conducting several clinical trials in the near future. In many developing countries, the incidence of stroke is quite high in patients with hypertension. China is not the only country where the number one of death is stroke.
Our findings suggest that hypertensive patients are more vulnerable to suffering from first-time stroke; therefore, they must incorporate folic acid supplements along with their daily dosage of medications. Each individual’s genetic, clinical, and nutritional characteristics must be taken into account while administering folic acid supplements. Folic acid supplements could be the most cost-effective strategy of preventing stroke in Chinese patients.
These recent findings were further affirmed by David Spence, MD, who works as the Director of Stroke Prevention and Atherosclerosis Research Center at Robarts Research Institute. He noted that hypertensive patients may also suffer from vitamin B12 deficiency; these patients are more prone to having lower levels of platelet count and higher levels of homocysteine.
There is a strong correlation between vitamin B12 deficiency and high levels of homocysteine. He further stated that most studies have spread misleading information of vitamin B12 being not linked with the risk of stroke. This study proved that vitamin B12 is indeed beneficial for preventing strokes in patients with hypertension.