0
Letters |

Relationship of Dietary Folate and Vitamin B6 With Coronary Heart Disease in Women—Reply

Eric B. Rimm, ScD; Walter C. Willett, MD; Frank B. Hu, MD, PhD; Graham A. Colditz, MB, BS; Laura Sampson, MS; JoAnn E. Manson, MD, DrPH; Charles H. Hennekens, MD, DrPH; Meir J. Stampfer, MD, DrPH
JAMA. 1998;280(5):417-419. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-5-jbk0805.
Text Size: A A A
Published online

Extract

In Reply.— As stated in our article, clinical trials of folate and vitamin B6 supplementation in the prevention of CHD are warranted to determine the independent effects of these 2 vitamins and to rule out confounding variables. However, we disagree with Drs Cleophas and van der Meulen that the inverse association we reported is likely due to other lifestyle factors. Controlling for use of vitamin E supplements and smoking status slightly attenuated the RR of CHD among women with the highest intakes of folate and vitamin B6, but accounting for other known cardiovascular risk factors (eg, physical activity, body weight) made little further difference. For factors such as job demand or psychosocial factors to attenuate further this RR, they would need to be strongly related to intake of folate and vitamin B6 and be strong predictors of CHD independent of other factors already accounted for in our analysis. This seems unlikely. Further, if self-selection of healthy individuals into the highest quintiles of intake were to explain our results, we would expect other micronutrients to be similarly related to CHD risk; we did not find inverse associations for vitamin C, thiamin, and riboflavin.

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();