Folates and cardiovascular disease

Arterioscler Thromb Vasc Biol. 2002 Jan;22(1):6-13. doi: 10.1161/hq0102.102190.


It is increasingly recognized that folates may play a role in the prevention of cardiovascular disease. Over the last few years, several studies have reported beneficial effects of folates on endothelial function, a surrogate end point for cardiovascular risk. Consistently, observational studies have demonstrated an association between folate levels and cardiovascular morbidity and mortality. The exact mechanisms underlying the ameliorative effects of folates on the endothelium remain to be elucidated. Thus far, most studies have focused on the homocysteine-lowering effects of folates. However, recently, benefits of folates independent of homocysteine lowering have also been reported. Potential mechanisms include antioxidant actions, effects on cofactor availability, or direct interactions with the enzyme endothelial NO synthase. Obviously, beneficial effects of folates on cardiovascular risk would have important clinical and dietary consequences. However, for definite conclusions, the completion of ongoing randomized controlled trials will have to be awaited.

Publication types

  • Review

MeSH terms

  • Arteriosclerosis / metabolism
  • Arteriosclerosis / prevention & control
  • Biopterins / analogs & derivatives*
  • Biopterins / metabolism
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology*
  • Endothelium, Vascular / physiology*
  • Folic Acid / physiology*
  • Folic Acid / therapeutic use
  • Folic Acid Deficiency / complications*
  • Homocysteine / blood*
  • Humans
  • Methylenetetrahydrofolate Dehydrogenase (NAD+)
  • Nitric Oxide Synthase / metabolism
  • Nitric Oxide Synthase Type III
  • Oxidative Stress / physiology
  • Oxidoreductases / physiology


  • Homocysteine
  • Biopterins
  • Folic Acid
  • Oxidoreductases
  • NOS3 protein, human
  • Nitric Oxide Synthase
  • Nitric Oxide Synthase Type III
  • Methylenetetrahydrofolate Dehydrogenase (NAD+)
  • sapropterin