Mr. Li is 72 years old this year and has been diagnosed with hypertension for several years. After diagnosis, he has been following the doctor’s advice to take medication, have regular check-ups, and maintain healthy lifestyle habits, so his blood pressure is well controlled.
However, during his last check-up last week, he asked the doctor to prescribe him folic acid because someone told him that hypertensive patients taking folic acid can prevent stroke.
Upon hearing Mr. Li’s words, the doctor was a bit puzzled. While it is true that some hypertensive patients may need to supplement folic acid, for patients like Mr. Li who are normal in all aspects, maintaining the current situation is sufficient, and there is no need for additional folic acid supplementation.
Why do some hypertensive patients need to take folic acid?
Folic acid, actually vitamin B9, is a water-soluble vitamin commonly used in clinical practice for pregnancy preparation. However, some hypertensive patients may find folic acid in the medications prescribed by their doctors. Why is this so?
There is a type of hypertension called H-type hypertension, which is hypertension with hyperhomocysteinemia. Homocysteine not only easily causes blood pressure to rise but is also an independent risk factor for cardiovascular diseases like stroke and coronary heart disease.
Research data shows that individuals with high homocysteine levels have an 87% increased risk of stroke, a 31% increased risk of stroke recurrence, and a 47% increased risk of all-cause mortality.
Folic acid and vitamin B6 play a crucial role in homocysteine metabolism in the blood. When there is insufficient folic acid or B vitamins in the body, it can lead to a blockage in homocysteine metabolism, resulting in elevated homocysteine levels. Therefore, hypertensive patients with H-type hypertension need to take folic acid to regulate homocysteine levels, not to lower blood pressure.
However, not all hypertensive patients need to take folic acid, and folic acid is not a routine preventive medication for hypertension. Blind folic acid supplementation for patients other than those with H-type hypertension may not only lower blood pressure but also lead to complications.
How should patients with H-type hypertension supplement folic acid?
According to the “Diagnosis and Treatment Expert Consensus on H-type Hypertension” developed by Chinese experts, there are two main supplementation methods. First, prioritize dietary supplementation, such as eating more animal liver, green leafy vegetables, legumes, and citrus fruits; second, take folic acid supplements at a dose of 0.8 mg/day for over three years continuously, but specific usage should still follow medical advice.
Middle-aged and elderly individuals who moderately supplement folic acid may experience 5 benefits
Folic acid is an important coenzyme in the process of cell DNA synthesis, participating in amino acid and nucleic acid synthesis, and playing a crucial role in cell replication, division, tissue differentiation, and more.
The body’s metabolism relies on folic acid participation. Folic acid is not only exclusive to pregnant women but also has a beneficial role in the health of middle-aged and elderly individuals, particularly in preventing various common diseases in this age group.
1. Reducing the risk of cardiovascular diseases
Folic acid can reduce blood glycine levels, thereby reducing the risk of cardiovascular diseases and arterial hardening by decreasing homocysteine levels in the blood.
2. Reducing the risk of dementia in the elderly
Supplementing folic acid in the elderly can reduce harmful substances’ damage to brain blood vessels, produce neurotrophic factors, reduce brain nerve damage, and have a certain benefit in preventing cognitive decline and dementia in old age.
3. Improving chronic atrophic gastritis
Research has found that moderate folic acid and vitamin B12 supplementation can improve chronic atrophic gastritis and reverse intestinal metaplasia.
4. Preventing anemia
Folic acid is essential for cellular growth and reproduction within the body and is one of the raw materials for blood production. Inadequate folic acid in the body can lead to abnormal red blood cells, hindering normal red blood cell production and causing anemia. Adequate folic acid supplementation can help prevent anemia.
5. Reducing adverse reactions caused by rheumatoid autoimmune disease medications
Treatment for rheumatoid autoimmune diseases generally involves methotrexate drugs, which can lead to gastrointestinal reactions, oral ulcers, liver damage, and other side effects. Supplementing folic acid while taking medication can reduce the occurrence of adverse reactions.
Supplementing folic acid scientifically – pay attention to these 3 details
Folic acid is very important for health, and paying attention to these details during supplementation can help the body absorb and utilize it better.
1. Eat more of four high-folic acid foods
Fruits: Kiwi, dragon fruit, bananas, jujubes, and other fruits have rich folic acid content.
Vegetables: Vegetables with abundant chlorophyll have high folic acid content, with darker green leafy vegetables having higher folic acid content, such as spinach, lettuce, cauliflower, Chinese kale, and rapeseed greens.
In addition, folic acid is sensitive to light, so it is advisable to eat fresh vegetables daily and avoid storing them for too long.
Staple foods: Coarse grains like brown rice, oats, legumes, etc., have rich folic acid content and can be consumed in combination with refined grains in daily diets.
Animal offal: Pig liver and chicken liver also contain abundant folic acid components. For individuals with normal blood lipids, consuming them in moderation for folic acid supplementation is beneficial, but do not overconsume – 1-2 times per week is sufficient.
2. Choose the appropriate cooking method
High-temperature cooking can lead to folic acid oxidation and loss. It is recommended to choose cold dishes or low-temperature cooking methods when preparing folic acid-rich foods.
3. Avoid long-term excessive supplementation
Currently, it is recommended that individuals with hyperhomocysteinemia supplement folic acid at 0.8mg per day. Long-term high-dose folic acid supplementation (>1.0mg/d) may increase the risk of cancer, worsen neurodegenerative diseases, affect zinc absorption, etc. Daily supplementation should be done under medical guidance and avoid self-medication.
Folic acid is not only necessary for pregnant women; hypertensive patients with elevated homocysteine levels also need to supplement it. Consult a professional healthcare provider before starting folic acid supplementation!
