Low-dose B Vitamins Supplementation Improves Framingham Risk Score: A Double Blind Randomized Controlled Trial in Healthy Chinese Elderly

Abstract

Objectives: We investigated whether daily supplementation with low-dose B vitamins in healthy elderly improves Framingham risk score (FRS), a cardiovascular disease predictor. Methods: A double-blind randomized controlled trial was conducted in a rural area of North China during 2007-2012. 390 healthy participants aged 60-74 were randomly allocated to receive daily vitamin C (50 mg; control) or vitamin C plus B vitamins (400 µg folic acid, 2 mg B6, and 10 µg B12) for 12 months. The outcome was FRS. Results: Compared with control, supplementation with B vitamins reduced FRS by 3.7% (mean difference, -0.38; 95% CI -1.06, 0.31; P=0.279) at 6 months, 7.6% (-0.77; 95% CI -1.47, -0.06; P=0.033) at 12 months, but this reduction effect vanished 6 months later after stopping supplementation (-0.7%; -0.07; 95% CI -0.80, 0.66; P=0.855). The reduction in FRS at 12 months after supplementation was more pronounced in individuals with folate deficiency (11.0%; -1.38; 95% CI -2.56, -0.20; P=0.023) than those without folate deficiency (5.0%; -0.47; 95% CI -1.20, 0.26; P=0.206). B vitamins elevated high-density lipoprotein cholesterol by 3.4% (0.04 mmol/L; 95% CI -0.02, 0.10; P=0.155) at 6 months, 9.2% (0.11 mmol/L; 95% CI 0.04, 0.18; P=0.003) at 12 months; the change magnitude declined to 3.3% (0.04 mmol/L; 95% CI -0.02, 0.10; P=0.194) after stopping supplementation, compared with control. Conclusions: Daily supplementation with low-dose B vitamins for 12 months reduced FRS, particularly in healthy elderly with folate deficiency. These reduction effects declined after stopping supplementation, indicating a need for persistent supplementation to maintain the benefits.