folic acid

Diabetes is a known risk factor for stroke, however, the exact effect of high fasting blood glucose concentrations on first stroke incidents has yet to be thoroughly investigated. A new study has determined that a high fasting blood glucose concentration equal to or higher than 7.0 mmol/L can increase first stroke risk, which can be significantly decreased by taking folic acid supplements.


It has been known that those with high fasting blood glucose concentrations or individuals suffering from diabetes are at a higher risk of stroke, however, the exact impact of this factor on the increased risk has not been thoroughly studied. Looking for preventative measures, specifically, risk factors that can be easily modifiable, as well as safe, cheap, and effective methods, are very important to help reduce the population’s stroke incidence statistics. Folic acid, which is an essential B vitamin and a synthetic form of folate, has recently been studied as a way to reduce the risk factor of a first stroke incident, specifically in patients with high fasting blood glucose, and in regions where there is generally less folate available.

Xu et al, conducted a study to see if fasting blood glucose concentrations were, in fact, positively associated with first stroke risk, as well as if taking folic acid treatment prevented such a risk. The study recruited 20,327 hypertensive adults between the ages of 45-75 years from May 2008 to August 2013. The participants were from 32 communities across Jiangsu and Anhui, China. The participants had never had a case of stroke or myocardial infarction. The study used a randomized and double-blind technique, where about half of the participants took 10 mg of enalapril (an ACE inhibitor used to treat hypertension) and 0.8 mg of folic acid. The other half just took 10 mg of enalapril. It was found that those participants that had a high fasting blood glucose concentration (≥ 7.0 mmol/L) or those suffering from type 2 diabetes had a higher risk of stroke, in comparison to those with lower fasting blood glucose concentrations. It was also found that the folic acid treatment significantly reduced the risk of stroke across a variety of fasting blood glucose concentrations, concluding that having a fasting blood glucose concentration of or higher than 7.0 mmol/L increases an individual’s risk of suffering from stroke as a first event, but this can be reduced by 34% via folic acid treatment.

Currently, there is no official recommendation for folic acid supplements when attempting to prevent diabetes or stroke and if these findings are replicated in a future study, it should be considered as a strong preventative strategy.


Written By: Unaisa Bhayat, M. D. Candidate

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