本月JAMA的最新文章,中國的研究,於江蘇與安徽兩地,共收集了20702人的研究,這群人只有高血壓,而且過去沒有中風或者心肌梗塞的病史。
這群人分成兩組,一組人使用 enalapril + folic acid (即葉酸,劑量為 0.8mg) 的複方藥錠,另一組人使用只含有 enalapril 的藥錠,結果為:
使用含有葉酸藥錠那組高血壓患者,在4.5年的追蹤時間裡,罹患中風的機會比另一組人來的低,請看下圖:
有服用葉酸者,得到中風的風險比值能夠降到0.79,考慮到這篇的研究方法為大型雙盲,而且涵蓋人數這麼多,而且又是同樣黃種人(不談政治,只談科學),這篇的結果十分重要,而且可信度很高,補充葉酸那一組患者中,原本血中葉酸濃度較低者,獲益更大。後續雜誌編輯討論也稱此篇研究設計十分小心且聰明,也暗示這樣的結果,或許也能應用在正常血壓的人身上。
心得:中風的“初級預防”耶,意思是能夠預防第一次中風耶。看來,得要把葉酸的飲食建議,好好讀一讀,再來寫一篇囉。
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Y H, J L, X Q, al et. Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in china: The csppt randomized clinical trial.
JAMA. Published online 2015.
http://doi.org/10.1001/jama.2015.2274