Primary endpoint First stroke 27 vs 34 p 0003 s tronger benefit with lower folate levels Ischemic stroke 22 vs 28 p 0002 hemorrhagic stroke 056 vs 06 p 071 ID: 933222
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Enalapril(n = 10,354)
CSPPT
Primary endpoint: First stroke: 2.7% vs. 3.4%, p = 0.003; stronger benefit with lower folate levelsIschemic stroke: 2.2% vs. 2.8%, p = 0.002; hemorrhagic stroke: 0.56% vs. 0.6%, p = 0.71CV death/MI/stroke: 3.1% vs. 3.9%, p = 0.002; MI: 0.24% vs. 0.23%, p = 0.89
Trial design: Chinese patients with hypertension but without prior stroke or MI were randomized in a 1:1 fashion to either a fixed-dose combination of enalapril 10 mg/folic acid 0.8 mg daily or enalapril 10 mg daily. They were followed for a median of 4.5 years.
Results
Conclusions
Huo Y, et al. JAMA 2015;Mar 15:[Epub]
Folic acid + enalapril(n = 10,348)
Primary endpoint
Oral folic acid supplementation with enalapril is superior to enalapril alone in the primary prevention of stroke in patients with hypertension. Landmark finding that may change clinical practice globallyEspecially pertinent in countries/areas where fortification of food with folic acid is not a common practice, and where baseline folate levels are low
%
(
p = 0.003)