B Vitamins Support Heart Health

Promise of B vitamins and Omega-3 Fats for those Undergoing Heart Procedures

A common procedure for some patients with coronary artery disease is balloon angioplasty, also called percutaneous tansluminal coronary angioplasty or PTCA. PTCA is used to widen narrowed arteries by enlarging the inner diameter of the vessel so blood can flow more easily. About one-third of patients who undergo PTCA experience restenosis within six months of the procedure. Restinosis means that the widened segment of the vessels narrows again. Sometimes a wire mesh tube called a stent is put in place to hold an artery open. However, re-closure of the artery - even with a stent - can still be a problem. Since many patients have to undergo another angioplasty when restenosis occurs, researchers are trying to find ways to prevent this from happening.

The Swiss Heart Study: B-Vitamins Improve Angioplasty Outcome

At least 80 studies from around the world suggest that getting enough folic acid and vitamins B6 and B12 can help maintain a healthy heart and blood vessels, which are critical in preventing heart attacks and stroke. Investigators have recently found that high doses of these three vitamins can also help people who must undergo angioplasty.

The research team previously studied about 200 angioplasty patients who were given the three B-vitamins or placebo over a six-month period. The patients who took the vitamin combination showed a significant reduction in the development of restenosis compared to those who received the placebo (1). In their new study (Swiss Heart Study), the researchers increased the number of patients and extended the follow-up time to one year. They found that the vitamin regimen decreased by over 30% the need for repeat angioplasties or heart by-pass operations (2). It appears that the vitamins work by lowering blood levels of homocysteine, an amino acid that can build-up in the body and cause vascular damage.

Fish Oil May Help Prevent Restenosis

Population-health studies have linked higher intake of fish and omega-3 fatty acids with a lower risk of coronary heart disease in men, and a recent report indicates this relationship holds true for women as well (3). Researchers have speculated that omega-3 fatty acids may also help reduce restenosis after angioplasty, particularly if taken long enough before the procedure.

To test this theory, over 250 patients scheduled for PTCA were given either high dose omega-3 supplements or placebo for one month prior to and after the procedure, then continued on a lower dose for six months. Patients in the fatty acid group showed a modest but significant reduction in the rate of restenosis (4). The omega-3's may help by reducing the proliferation of smooth muscle cells into injured vessel walls, a process that contributes to restenosis.

An Ounce of Prevention . . .

For the general population, it is important to make sure that we obtain the right nutrients in order to keep our hearts healthy. To promote artery and heart health, make cold-water fish like salmon, tuna and sardines a regular part of your diet. Take a high-quality multivitamin and include good sources of important B-vitamins: green leafy vegetables and fortified cereal grains (folic acid), and beans, nuts, legumes, eggs, meats, fish, and whole grains (B6). The only foods that contain vitamin B12 are animal foods such as eggs, meat, poultry, shellfish, and dairy.

References

1. Schnyder G, et al. Decreased rate of coronary restenosis with lowering of plasma homocysteine levels. New Eng J of Med 345:1593-1600, 2001.
2. Schnyder G, et al. Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention. The Swiss Heart Study. JAMA 288:973-79, 2002.
3. Hu FB, et al. Fish and omega-3 fatty acid intake and risk of coronary heart disease in women. JAMA 287:1815-21, 2002.
4. Maresta A, et al. Prevention of post-coronary angioplasty restenosis by omega-3 fatty acids: Main results of ESPRIT. Am Heart J 143(6):e5, 2002.