Homocysteine Lowering with Folic Acid and B Vitamins in Vascular Disease

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2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease (2016, background): “The HOPE-2 trial randomized 5,522 patients with atherosclerotic vascular disease, including symptomatic PAD, or diabetes mellitus with additional risk factors to receive folic acid/vitamin B6/vitamin B12 or placebo (205,206).”
Mechanisms of diabetic complications. (2013, methodology): “The Heart Outcomes Prevention Evaluation (HOPE-2) study found no effect of high-dose B6, B9, and B12 cosupplementation on death from cardiovascular disease, while the risk of unstable angina was actually increased (351).”
Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). (2007, background): “Two studies of supplemental B vitamins and folic acid in patients with CAD demonstrated no benefit and even a suggestion of harm, so this therapy cannot be recommended.(55,56)”
2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. (2014, background): “Folic acid, with or without vitamins B6 and B12, should not be used for secondary prevention in patients with NSTE-ACS (256,257).”