Biomedical Bulletin


Biomedical Bulletin
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Folic Acid Helps Prevent High Blood Pressure
Massive study of American nurses shows the benefits of high daily intake

f you’re a young woman, take folic acid supplements. If you’re an older woman, take folic acid supplements. (If you’re sort of in between, well, you figure it out.) That’s the implicit message from the results of a major study on the relationship between folic acid and high blood pressure in women, reported in October 2004 at the American Heart Association’s 58th Annual High Blood Pressure Research Conference in Chicago.1

Folic Acid Fights Homocysteine

Folic acid—also called folate or folacin—is a B-vitamin without a number. Despite that handicap, it is well known to women for its important role in helping to prevent certain types of neurological birth defects, such as spina bifida. And health-conscious people of both sexes have become increasingly aware in recent years that folic acid helps to prevent cardiovascular disease by reducing our blood levels of a deleterious amino acid called homocysteine. This is important because our homocysteine levels tend to increase as we age.

29% Lower Risk with High Folic Acid Intake

Now there is strong evidence (but it’s not proof) that folic acid reduces the risk for hypertension in women. Dr. John P. Forman of the Brigham and Women’s Hospital in Boston, the lead investigator of the not-yet-published study, reported that young women who consumed 800 mcg (micrograms) or more of folic acid per day for 8 years had a 29% lower risk for hypertension than women who consumed 200 mcg/day or less. In older women, the risk reduction was less, but still substantial: 13%. There was also a somewhat reduced risk in those women who consumed 400 to 600 mcg/day, but the effect was not statistically significant.

The study participants were 62,260 women, aged 43–70, from the Nurses’ Health Study I, and 93,034 women, aged 26–46, from the Nurses’ Health Study II. (These are ongoing, long-term epidemiological studies of the health of female American nurses in relation to their lifestyles: diet, exercise, medications, supplements, alcohol and tobacco use, etc.) None of the women had high blood pressure at the outset of this study. They answered detailed questionnaires regarding their dietary intake, including nutritional supplements, at the outset and again at 4-year intervals; they also reported any physician-diagnosed blood pressure every 2 years during the 8-year follow-up period.

Food Is Inadequate as a Source of Folic Acid

Since January 1998, several types of foods in the United States, notably cereals and bread, have been fortified with folic acid in amounts sufficient to add about 100 mcg/day to the average diet. The FDA mandated this practice because dietary deficiencies of folic acid had been common. Even with this enforced supplementation, however, it’s difficult to get adequate amounts of folic acid from food alone. Dr. Forman noted that virtually all the women in his study who consumed 800 mcg/day or more took supplements. (Most conventional multivitamin formulations contain 400 mcg of folic acid per daily serving.)

A Spectrum of Health Benefits

It’s important to note that folic acid should always be taken in conjunction with vitamin B12, because too much of one can mask a deficiency in the other; for all practical purposes, these two B-vitamins should be regarded as inseparable. In addition to folic acid’s role in reducing the risk for hypertension and helping to prevent cardiovascular disease, there is evidence that it may help decrease the risk of Alzheimer’s disease and other neurodegenerative disorders. It also reduces the risk of certain cancers, and, together with B12, it is believed to help reduce the risk of bone diseases such as osteoporosis.


  1. American Heart Association. Folate intake lowers women’s risk of high blood pressure. Press release, Oct. 11, 2004.

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