SynthesisPloS one2011
Effect of folic acid supplementation on cardiovascular outcomes: a systematic review and meta-analysis.
Synthesis in PloS one, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 10 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Efficacy and safety of folic acid on homocysteine and cardiovascular surrogate biomarkers in hyperhomocysteinemia: a systematic review and meta-analysis of RCTs.BMC nutrition · 2026Pooled it
- Folate and global health umbrella review series, part 2: syntheses on cancers.Journal of global health · 2026Pooled it
- Folic acid for the primary prevention of stroke: a systematic review and meta-analysis.Frontiers in nutrition · 2024Pooled it
- Association Between Folate and Health Outcomes: An Umbrella Review of Meta-Analyses.Frontiers in public health · 2020Pooled it
- Homocysteine-lowering interventions for preventing cardiovascular events.The Cochrane database of systematic reviews · 2017Pooled it
- Folic Acid Supplementation and the Risk of Cardiovascular Diseases: A Meta-Analysis of Randomized Controlled Trials.Journal of the American Heart Association · 2016Pooled it
- Pooled it
- Pooled it
- The differences in homocysteine level between obstructive sleep apnea patients and controls: a meta-analysis.PloS one · 2014Pooled it
- Efficacy of vitamin and antioxidant supplements in prevention of cardiovascular disease: systematic review and meta-analysis of randomised controlled trials.BMJ (Clinical research ed.) · 2013Pooled it
- High levels of circulating folate concentrations are associated with DNA methylation of tumor suppressor and repair genesClinical epigenetics · 2017Trial
- Randomized multicenter investigation of folate plus vitamin B12 supplementation in schizophrenia.JAMA psychiatry · 2013Trial
- The complex link of the folate-homocysteine axis to myocardial hypertrophy and heart failure: from mechanistic exploration to clinical vision.Journal of advanced research · 2026Review
- Folate and global health review series, part 3: syntheses on cardiovascular, cerebrovascular, and metabolic diseases.Journal of global health · 2026Review
- High-dose folic acid supplement is associated with increased cardiovascular risk in rheumatoid arthritis patients on methotrexate.Therapeutic advances in musculoskeletal disease · 2026Article
- Homocysteine in the Cardiovascular Setting: What to Know, What to Do, and What Not to Do.Journal of cardiovascular development and disease · 2025Review
- How Increased Dietary Folic Acid Intake Impacts Health Outcomes Through Changes in Inflammation, Angiogenesis, and Neurotoxicity.Nutrients · 2025Review
- Folate induces stemness and increases oxygen consumption under glucose deprivation by notch-1 pathway activation in colorectal cancer cell.Molecular and cellular biochemistry · 2025Article
- Dietary folate intake and serum klotho levels in adults aged 40-79 years: a cross-sectional study from the national health and nutrition examination survey 2007-2016.Frontiers in nutrition · 2024Article
- Prevalence and clinical correlates of hyperhomocysteinemia in Chinese urban population with hypertension.Frontiers in endocrinology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFolic acid is widely used to lower homocysteine concentrations and prevent adverse cardiovascular outcomes. However, the effect of folic acid on cardiovascular events is not clear at the present time. We carried out a comprehensive systematic review and meta-analysis to assess the effects of folic acid supplementation on cardiovascular outcomes. METHODOLOGY AND PRINCIPAL
findingsWe systematically searched Medline, EmBase, the Cochrane Central Register of Controlled Trials, reference lists of articles, and proceedings of major meetings for relevant literature. We included randomized placebo-controlled trials that reported on the effects of folic acid on cardiovascular events compared to placebo. Of 1594 identified studies, we included 16 trials reporting data on 44841 patients. These studies reported 8238 major cardiovascular events, 2001 strokes, 2917 myocardial infarctions, and 6314 deaths. Folic acid supplementation as compared to placebo had no effect on major cardiovascular events (RR, 0.98; 95% CI, 0.93-1.04), stroke (RR, 0.89; 95% CI,0.78-1.01), myocardial infarction (RR, 1.00; 95% CI, 0.93-1.07), or deaths from any cause (RR, 1.00;95% CI, 0.96-1.05). Moreover, folic acid as compared to placebo also had no effect on the following secondary outcomes: risk of revascularization (RR, 1.05; 95%CI, 0.95-1.16), acute coronary syndrome (RR, 1.06; 95%CI, 0.97-1.15), cancer (RR, 1.08; 95%CI, 0.98-1.21), vascular death (RR, 0.94; 95%CI,0.88-1.02), or non-vascular death (RR, 1.06; 95%CI, 0.97-1.15). CONCLUSION/SIGNIFICANCE: Folic acid supplementation does not effect on the incidence of major cardiovascular events, stroke, myocardial infarction or all cause mortality.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.