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4.4 The Effect of B-Vitamin Supplementation on Arterial Stiffness in Elderly



Hyperhomocysteinemia is an important cardiovascular risk indicator in the oldest old and is also associated with elevated arterial stiffness in this age group. Several intervention trials reported a lack of benefit of B-vitamin supplementation on cardiovascular outcomes, therefore we aimed to investigate the effect of B-vitamin supplementation on arterial stiffness and cardiovascular events in hyperhomocysteinemic elderly subjects.

Methods and Results

The B-PROOF study is a double-blind randomized-controlled trial, including 2919 elderly (≥ 65 years), with hyperhomocysteinemia (12–50 µmol/l), treated with B-vitamins (500 µg vitamin B12 and 400 µg folic acid) or placebo for 2 years. In a subgroup (n = 569) the effect of B-vitamins on pulse wave velocity (PWV) was investigated. In the total B-PROOF population, incidents of cardiovascular and cerebrovascular events were determined via structured questionnaires and also blood pressure was measured. Compared to placebo, B-vitamins lowered serum homocysteine by 3.6 µmol/L (p<0.001). Analysis of covariance showed no effect of B-vitamins supplementation on PWV levels, but aortic pulse pressure was higher in the intervention than in the placebo group (49.6 mmHg vs. 47.2 mmHg; p = 0.02). Furthermore, a significant reduction of cerebrovascular events in females (OR 0.33 95%CI [0.15 ; 0.71]), but not in males was observed.


B-vitamins supplementation in hyperhomocysteinemic elderly has no effect on PWV and caused a modest increase in aortic pressure, but also a reduction in cerebrovascular events in females. Arterial stiffness is not likely to be the underlying pathway of the negative trial outcomes.

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Van Dijk, S., Smulders, Y., Enneman, A. et al. 4.4 The Effect of B-Vitamin Supplementation on Arterial Stiffness in Elderly. Artery Res 8, 127 (2014).

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