A recent study published in the Journal of the American Medical Association has concluded that folic acid taken with the blood pressure medication enalapril is more effective in reducing stroke than enalapril alone.
A total of 20,702 adults with hypertension without history of stroke or myocardial infarction took part in The China Stroke Primary Prevention Trial, a randomized, double-blind clinical trial, conducted from 2008 to 2013. The participants were randomly given a single-pill containing 10mg enalapril and 0.8 mg folic acid or a tablet containin10mg enalapril alone.
The researchers found that compared with the enalapril alone group, the enalapril–folic acid group had a significant risk reduction in first stroke at 2.7% compared to 3.4%, meaning an absolute risk reduction of 0.7% and a relative risk reduction of 21%.
They also found that risk reduction of first ischemic stroke was 2.2% with combined pill against 2.8% with enalapril alone; and risk reduction of composite cardiovascular events consisting of cardiovascular death, myocardial infarction (MI), and stroke was 3.1% compared with 3.9% with enalapril alone.
The researchers concluded: “Among adults with hypertension in China without a history of stroke or MI, the combined use of enalapril and folic acid, compared with enalapril alone, significantly reduced the risk of first stroke. These findings are consistent with benefits from folate use among adults with hypertension and low baseline folate levels.”
