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Vitamin B Does Not Guard Against Repeat Stroke


You've had a stroke or transient ischemic attack (TIA), will taking vitamin B supplements help prevent another one?

Not likely according to Graeme Hankey, MD, of Royal Perth Hospital in Australia, and colleagues.

B Vitamins Don't Cut Repeat Stroke Risk

The results of their clinical trial has been published online in The Lancet Neurology. Between Nov 19, 1998, and Dec 31, 2008, the researcher conducted the randomized, double-blind, parallel, placebo-controlled trial included 8164 patients with recent stroke or TIA (within the past 7 months) in 20 countries from 123 medical centers. The patients were assigned to receive one tablet daily of placebo (4,075) or B vitamins (4,089). The vitamin supplement contained 2 mg folic acid, 25 mg vitamin B6, and 0·5 mg vitamin B12.

The primary endpoint was the composite of stroke, myocardial infarction, or vascular death. All patients randomly allocated to a group were included in the analysis of the primary endpoint.

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Patients were followed up for a median duration of 3·4 years. There was no significant difference between the two groups in the numbers who reached the primary endpoint: 616 (15%) patients assigned to B vitamins and 678 (17%) assigned to placebo.

This translates into an absolute risk reduction of only 1·56% which the researchers interpret as not supporting the use of B vitamins to prevent recurrent stroke.

Five things you can do to help prevent strokes:

  • Eat a healthy diet. Be sure to eat plenty of fresh fruits and vegetables. Eating foods low in saturated fat and cholesterol and high in fiber can help prevent high blood cholesterol. Limiting salt or sodium in your diet can also lower your blood pressure.
  • Maintain a healthy weight. Being overweight or obese can increase your risk for stroke.
  • Be active. Physical activity can help you maintain a healthy weight and lower cholesterol and blood pressure. Aim for at least 30 minutes of moderate -intensity exercise on most days of the week.
  • Don't smoke. Cigarette smoking greatly increases your risk for stroke. If you do smoke, quitting will lower your risk.
  • Limit alcohol use. Avoid drinking too much alcohol, which causes high blood pressure.

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Hankey G, et al "B vitamins in patients with recent transient ischemic attack or stroke in the Vitamins to Prevent Stroke (VITATOPS) trial: a randomized, double-blind, parallel, placebo-controlled trial" Lancet Neurol 2010; DOI: 10.1016/S1474-4422(10)70187-3.

Centers for Disease Control and Prevention