In a new study, researchers found that low folate levels in the bloodstream are linked to an increased risk of heart disease death risk in patients with rheumatoid arthritis.
The finding sheds light on why those patients are more susceptible to heart and vascular disease.
The research was conducted by experts at The University of Texas Health Science Center at Houston (UTHealth).
Rheumatoid arthritis is an autoimmune disorder that causes inflammation due to immune system attacks on healthy cells.
It can lead to permanent tissue and joint damage. Women are 2-3 times more likely to develop the disease.
Patients with rheumatoid arthritis are 60% more likely to die from heart disease, but researchers have not been able to explain why.
In the study, the researchers tested 683 patients with a self-reported diagnosis of rheumatoid arthritis.
Participants were divided into three groups based on their measured serum folate levels.
Over the course of 17 years, 258 cardiovascular deaths occurred.
The serum folate level below 4.3 nanograms per milliliter was linked to 50% higher cardiovascular mortality risk in rheumatoid arthritis patients.
The findings suggest that serum folate levels might be a useful indicator to assess the cardiovascular mortality risk of a rheumatoid arthritis patient in clinical practice.
This study is the first to show an association between serum folate and increased heart disease death risk in patients with rheumatoid arthritis.
It’s particularly important for patients taking disease-modifying anti-rheumatic drugs to understand this increased risk.
Serum folate, more commonly known as folic acid, is a B vitamin that is essential in the creation of new cells and has a homocysteine-lowering effect.
Homocysteine is an amino acid found in blood, and high levels have been linked to a greater risk of developing cardiovascular disease.
People with rheumatoid arthritis often have an increased amount of homocysteine, an imbalance that may be due to common medications prescribed for rheumatoid arthritis, such as methotrexate, which depletes folate levels.
Folic acid is found in many foods such as eggs, broccoli, citrus fruits, and leafy greens.
Healthy adults should consume at least 400 mcg daily, but study authors say folate-rich foods may not be enough to prevent cardiovascular disease for people with rheumatoid arthritis.
Diets high in animal protein such as red meat and increased coffee consumption have been linked to higher homocysteine levels.
Avoiding red meats and coffee and eating a diet rich in fruits and vegetables, in addition to taking a daily folic acid supplement, can help reduce homocysteine blood levels.
The lead author of the study is Kalyani Sonawane, Ph.D., an assistant professor at UTHealth School of Public Health.
The study is published in JAMA Network Open.
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