We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
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


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.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also 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.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
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.


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

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

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