Evidence map›Paper›PMID 42410840›Full record

ArticleMedicine2026

Impact of folic acid supplementation on cardiovascular risk among individuals with hemorrhagic stroke: A prospective study.

Dapeng Dai, Yong Sun, Hongwei Zhang, Aimin Li

Abstract read
In one paragraph

Article in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Dapeng DaiDepartment of Neurosurgery, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China.
Yong Sun
Hongwei Zhang

Funding

the study on secondary prevention of stroke in H-type hypertension population based on precision treatment in the 2020 medical research project of Jiangsu Provincial Health and Health Commission ZDA2020018
6 · The paper itself

Abstract

This study explored the association between enalapril-folic acid treatment and the likelihood of developing cardiovascular disease (CVD) in patients with hemorrhagic stroke combined with H-type hypertension. This prospective study involved 799 patients diagnosed with hemorrhagic stroke and H-type hypertension (defined as total homocysteine levels ≥ 10 μmol/L). Patients were instructed to take a daily regimen of enalapril (10 mg) and folic acid (0.8 mg) and were monitored for a median duration of 9.6 months. Adherence to the treatment was classified as either high (≥ 70%) or low (< 70%). The study's primary endpoint comprised a combination of CVD events, such as cardiovascular mortality, nonfatal myocardial infarction, and nonfatal stroke. The relationship between adherence to treatment and clinical outcomes was analyzed using Cox proportional hazards models, controlling for confounding factors. Subgroup analyses investigated interactions within stratifications of sex, age (< 65 vs ≥ 65 years), body mass index (< 24 vs ≥ 24 kg/m2), seated blood pressure (< 160 vs ≥ 160 mm Hg), total cholesterol (< 4.6 vs ≥ 4.6 mmol/L), and total homocysteine (< 13.7 vs ≥ 13.7 μmol/L). During the follow-up, 40 participants (5.0%) developed CVD, and 21 participants (2.6%) experienced recurrent hemorrhagic stroke. Patients with high adherence to enalapril-folic acid therapy exhibited significantly reduced risks of CVD (hazard ratio [HR]: 0.16; 95% confidence interval [CI]: 0.06-0.45), recurrent hemorrhagic stroke (HR: 0.21; 95% CI: 0.07-0.67), and all-cause mortality (HR: 0.14; 95% CI: 0.05-0.41) when compared to those with low adherence. Greater compliance with enalapril-folic acid therapy was associated with decreased CVD and recurrent hemorrhagic stroke incidence in hypertensive individuals with elevated homocysteine levels. The results indicated that folic acid supplementation may be a promising strategy for secondary stroke prevention. Nonetheless, further randomized controlled trials are required to confirm its efficacy.

Indexed as

Cardiovascular DiseasesDietary SupplementsEnalaprilFolic AcidHemorrhagic StrokeStrokeAgedAntihypertensive AgentsFemaleHeart Disease Risk FactorsHomocysteineHumansHypertensionMaleMiddle AgedProportional Hazards ModelsAntihypertensive AgentsEnalaprilFolic AcidHomocysteinecardiovascular diseasesfolic acidhemorrhagic strokehomocysteinehypertension

Identifiers

PMID42410840
PMCPMC13337008

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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.