TY - JOUR T1 - Lowering homocysteine with folic acid and B vitamins did not prevent vascular events in vascular disease JF - Evidence Based Medicine JO - Evid Based Med SP - 104 LP - 104 DO - 10.1136/ebm.11.4.104 VL - 11 IS - 4 A2 - , Y1 - 2006/08/01 UR - http://ebm.bmj.com/content/11/4/104.abstract N2 - Lonn E, Yusuf S, Arnold MJ, et al. Homocysteine lowering with folic acid and B vitamins in vascular disease. N Engl J Med 2006;354:1567–77.OpenUrlCrossRefPubMedWeb of Science 
 
 Q In patients with vascular disease, does lowering plasma homocysteine concentrations with folic acid and B vitamins reduce risk of major vascular events? Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Neurology ★★★★★★☆ Cardiology ★★★★★★☆ Endocrine ★★★★★☆☆ Design randomised placebo controlled trial (Heart Outcomes Prevention Evaluation [HOPE] 2 trial). Allocation concealed.* Blinding blinded {clinicians, patients, data collectors, outcome assessors, and data analysts}†.* Follow up period mean 5 years. Setting 145 centres in 13 countries (Canada, USA, Brazil, western Europe, and Slovakia). Patients 5522 patients ⩾55 years of age (mean age 69 y, 72% men) with a history of coronary artery, cerebrovascular, or peripheral artery disease, or diabetes with ⩾1 risk factor for atherosclerosis. Exclusion criteria included planned revascularisation and other types of significant cardiovascular disease (CVD). Intervention a combined pill with 2.5 mg folic acid, 50 mg vitamin B6, and 1 mg vitamin B12 taken once daily (n = 2758) or placebo (n = 2764). Outcomes a composite end point of MI, stroke, or death from CV causes. Secondary outcomes included total ischaemic events (primary outcome components plus hospital admission for unstable angina or revascularisation), death from any cause, hospital admission for unstable angina, and revascularisation. Patient follow up 99% (intention to treat analysis). … ER -