Vitamin B vs. Heart Attacks and Stroke: It’s Complicated

Do you or someone you know take a form of vitamin B, such as cyanocobalamin (B12), pyridoxine (B6), or folic acid (B9), to improve your heart health? If so, you are not alone. A quick internet search reveals dozens of articles asserting that taking them will reduce your risk of heart attack and stroke. We know that vitamin B lowers your body’s levels of homocysteine. Many studies have found that people with higher levels of homocysteine also have higher rates of heart disease and stroke. Studies have also shown that people who have vitamin B deficiencies to a higher risk of heart disease and stroke. So if more vitamin B means less homocysteine, and less homocysteine means less heart disease and stroke, then more vitamin B means less heart disease and stroke, right?

It turns out it’s not so simple. A Cochrane team just released a review of all the trials published on vitamin B supplements and heart health from 2002 to 2015. The 15 studies involved a total of 71,422 participants. All the studies compared one or more vitamin B supplement with a control group of some kind. Overall, they found that people taking a placebo and/or receiving standard care showed the same rates of heart disease as people using the supplements. The authors concluded that there is no evidence that any form or dosage of B vitamins has any impact on heart disease risk.

The picture was slightly different for stroke risk. One large trial found a very small reduction in stroke risk for patients who took folic acid alongside their standard medication (enalapril). The reviewers recommended that future studies be focused on further clarifying whether adding vitamin B supplements to standard treatments might reduce stroke risk. Because multiple large, well-designed trials on the benefits of vitamin B supplementation alone on heart disease risk have now been executed, they concluded that additional trials on this question would be unlikely to produce different results.

Why didn’t vitamin B supplements make the difference many researchers expected? We don’t know, but part of the answer may lie in the difference between food and supplements. People with higher levels of vitamin B in their blood stream usually eat a diet rich in fruits and vegetables. Eating these foods may offer complex benefits not produced by supplements. Supplements have been shown to improve health in people with serious vitamin deficiencies. But once you reach the minimum amount your body needs, adding more may offer no additional health benefits.

So how can you reduce your heart disease risk? Multiple studies have shown that even small lifestyle changes can make a big difference. Hate vegetables? Here’s a list of 40 ways to sneak them into your diet. Hate the thought of the gym? The good news is that activities as simple as a stroll around the block can improve health. If you are overweight, even a very small weight loss can dramatically lower blood pressure and other risk factors. All of these things take much longer than popping a pill. But by taking these small steps every day, you can make big progress in keeping your heart healthy and happy.

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