The aim of this study was to evaluate the effectiveness of supplementation with folic acid in primary prevention of stroke in hypertensive patients. Patients were randomized 1:1 to a fixed combination of enalapril 10 mg and folic acid 0.8 mg daily (n = 10,348) or only 10 mg enalapril (n = 10,354) followed at a mean of 4.5 years. The study was terminated prematurely given the benefit for the combination enalapril / folic acid. The primary end point of first stroke was 2.7% for enalapril / folic combination versus 3.4% for enalapril alone (HR 0.79, p = 0.003) with a number needed to treat (NNT) of 141. The greatest benefit was observed in patients with lower basal levels of folate.

Conclusion

Oral supplement with folic acid added to enalapril was higher than enalapril alone in the primary prevention of stroke in hypertensive patients.

Huo Y
2015-03-17

Original title: Efficacy of Folic Acid Therapy in Primary Prevention of Stroke Among Adults With Hypertension in China: The CSPPT Randomized Clinical Trial.