Key result
Folic acid supplementation significantly improved flow-mediated dilation (SMD 0.888; 95% CI 0.447-1.329; p<0.001) compared to placebo, but did not significantly affect arterial stiffness.
Why the study?
Folic acid might improve endothelial function, but previous results remain inconclusive.
Does folic acid supplementation improve endothelial function and arterial stiffness in adults?
Meta-Analysis
Does folic acid supplementation improve endothelial function and arterial stiffness in adults?
Standardized Mean Difference: 0.888 (95% CI 0.447–1.329)
p-value: p=< 0.001
Folic acid supplementation may improve endothelial function markers such as flow-mediated dilation in adults, but does not appear to significantly affect arterial stiffness.
Folic acid may improve endothelial function without affecting arterial stiffness; extends RCT evidence but leaves clinical outcomes open pending larger trials.
Folic acid might improve endothelial function, but the results are inconclusive. This systematic review evaluated the effect of folic acid supplementation on endothelial parameters and arterial stiffness in adults. The study protocol was registered with the PROSPERO database (CRD42021290195). The PubMed, Web of Sciences, Cochrane and Scopus databases were searched to identify English-language randomised controlled trials of the effect of folate supplementation on arterial stiffness and endothelial function markers in adults. There were significant differences between the effect of folic acid and placebo on flow-mediated dilation (random-effects model, standardized mean differences (SMD): 0.888, 95% confidence interval (CI): 0.447, 1.329, p < 0.001) and monocyte chemotactic protein 1 (random-effects model, SMD: −1.364, 95% CI: −2.164, −0.563, p < 0.001), but there was no significant difference in the central pulse wave velocity (fixed-effects model, SMD: −0.069, 95% CI: −0.264, 0.125, p = 0.485) and peripheral pulse wave velocity (fixed-effects model, SMD: −0.093, 95% CI: −0.263, 0.077, p = 0.284). In conclusion, folic acid might have a favourable effect on endothelial function but may not affect arterial stiffness. Further studies are needed to confirm these results.
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Bokayeva et al. (2023) reported a meta-analysis. Folic acid supplementation vs. placebo was evaluated on flow-mediated dilation (SMD 0.888, 95% CI 0.447, 1.329, p=< 0.001). Folic acid supplementation significantly improved flow-mediated dilation (SMD 0.888; 95% CI 0.447-1.329; p<0.001) compared to placebo, but did not significantly affect arterial stiffness.
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