PMID- 35060542
OWN - NLM
STAT- MEDLINE
DCOM- 20220228
LR  - 20230103
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 101
IP  - 3
DP  - 2022 Jan 21
TI  - Effects of individualized administration of folic acid on prothrombotic state and 
      vascular endothelial function with H-type hypertension: A double-blinded, 
      randomized clinical cohort study.
PG  - e28628
LID - 10.1097/MD.0000000000028628 [doi]
LID - e28628
AB  - BACKGROUND: Hypertension and hyperhomocysteinemia (HHcy) have long been 
      associated with adverse cardiovascular and cerebrovascular health outcomes. This 
      study evaluated the effect of individualized administration of folic acid (FA) on 
      homocysteine (Hcy) levels, prothrombotic state, and blood pressure (BP) in 
      patients with H-type hypertension (combination of HHcy and hypertension). 
      METHODS: In this double-blinded, randomized clinical cohort study, 126 patients 
      with H-type hypertension who were treated at our hospital were randomly divided 
      into treatment and control groups (n = 55 each). The control group was treated 
      with oral levamlodipine besylate tablets 2.5 mg and placebo, once a day (in the 
      morning). The treatment group was first treated with oral levamlodipine besylate 
      2.5 mg and FA tablets 0.8 mg, once a day (in the morning), for 12 weeks. Then, in 
      a second 12-week phase, the FA dose was adjusted using the methylene 
      tetrahydrofolate reductase C677 polymorphism genotype. The levels of Hcy and 
      coagulation factors, prothrombotic state parameters, BP, and adverse drug 
      reactions were compared between the 2 groups. RESULTS: Pretreatment general 
      patient characteristics, including Hcy levels, were similar between the 2 groups 
      (P > .05). BP and prothrombotic status did not differ before and after the first 
      phase of treatment (P > .05). However, Hcy and endothelin-1 (ET-1) levels 
      decreased, while nitric oxide levels increased significantly in the intervention 
      group (P < .05). In the second phase, after 3 months' treatment with an FA dose 
      adjusted according to methylene tetrahydrofolate reductase C677T genotype, the 
      Hcy and ET-1/NO levels were significantly decreased in the intervention group and 
      were lower than those after the first treatment phase and lower than in the 
      control group (P < .01). BP, D-dimer levels, and fibrinogen scores were 
      significantly lower after the second treatment phase (P < .01). There was no 
      significant difference in the incidence of adverse drug reactions between the 2 
      groups (P > .05). CONCLUSIONS: Individualized administration of FA tablets can 
      effectively reduce BP, and Hcy and coagulation factor levels, and significantly 
      improve prothrombotic status in patients with H-type hypertension.
CI  - Copyright (c) 2022 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Zhang, Song
AU  - Zhang S
AUID- ORCID: 0000-0003-4465-0059
AD  - The First People's Hospital of Guangyuan, Sichuan, China.
FAU - Wang, Tianxun
AU  - Wang T
FAU - Wang, Huaiqi
AU  - Wang H
FAU - Tang, Jianping
AU  - Tang J
FAU - Hou, Ailin
AU  - Hou A
FAU - Yan, Xiaoling
AU  - Yan X
FAU - Yu, Baozhong
AU  - Yu B
FAU - Ran, Shuangming
AU  - Ran S
FAU - Luo, Min
AU  - Luo M
FAU - Tang, Ying
AU  - Tang Y
FAU - Yang, Ruohan
AU  - Yang R
FAU - Song, Dongsheng
AU  - Song D
FAU - He, Hanjun
AU  - He H
AUID- ORCID: 0000-0003-4465-0059
LA  - eng
GR  - 2019HR17/Sichuan Medical Association and Specialized scientific research fund 
      projects of HENG RUI/
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - 1J444QC288 (Amlodipine)
RN  - 885H5YC40L (levamlodipine besylate)
RN  - 935E97BOY8 (Folic Acid)
RN  - EC 1.5.1.20 (Methylenetetrahydrofolate Reductase (NADPH2))
SB  - IM
MH  - Amlodipine/*administration & dosage/adverse effects
MH  - Cohort Studies
MH  - Double-Blind Method
MH  - Drug-Related Side Effects and Adverse Reactions
MH  - Female
MH  - Folic Acid/*administration & dosage/adverse effects
MH  - Homocysteine/*blood
MH  - Humans
MH  - Hyperhomocysteinemia/*drug therapy
MH  - Hypertension/*drug therapy
MH  - Male
MH  - Methylenetetrahydrofolate Reductase (NADPH2)/genetics
MH  - Middle Aged
MH  - *Precision Medicine
MH  - Vascular Endothelial Growth Factor A
PMC - PMC8772678
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2022/01/22 06:00
MHDA- 2022/03/01 06:00
PMCR- 2022/01/21
CRDT- 2022/01/21 08:54
PHST- 2021/04/05 00:00 [received]
PHST- 2021/12/28 00:00 [accepted]
PHST- 2022/01/21 08:54 [entrez]
PHST- 2022/01/22 06:00 [pubmed]
PHST- 2022/03/01 06:00 [medline]
PHST- 2022/01/21 00:00 [pmc-release]
AID - 00005792-202201210-00049 [pii]
AID - MD-D-21-02618 [pii]
AID - 10.1097/MD.0000000000028628 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2022 Jan 21;101(3):e28628. doi: 
      10.1097/MD.0000000000028628.