Key findings from detailed records
In 20,702 Chinese adults with hypertension, adding folic acid 0.8 mg/day to enalapril reduced first stroke occurrence over a median 4.5 years (2.7% versus 3.4%). The combination, baseline folate status and clinical population are essential to interpreting this positive result.
KNOWLEDGE RECORD
- Category
- Vitamins and minerals
- Last Reviewed
Names and related search termsFolate / Folate / Folic acid / Folate
Study type: human intervention study.
OUTCOME-SPECIFIC EVIDENCE
Scientific Evidence Profile
Assessment pending
An outcome-specific assessment has not yet been completed. This is not a finding that the ingredient is ineffective. The study records below remain available.
This profile concerns the stated outcome and population, not the ingredient as a whole. It is not a probability of benefit, a safety rating, a product efficacy rating or an indication of product adoption.
How we assess evidenceIngredient Profile
- What is it, and where is it found?
- Folate is a water-soluble B vitamin. Food folate and folic acid are different forms; label units matter when comparing intakes. [1]
Sources for this profile
Compound properties and formulation properties are different. These sources do not establish the efficacy of a finished supplement.
- NIH Office of Dietary Supplements — Folate Nutrient identity and food-source reference. Published by NIH Office of Dietary Supplements. Reference synthesis; not an individual clinical trial.
Profile sources checked:
Read the evidence in context
- Evidence: what was measured in the stated population or experimental model.
- Inference: an interpretation connecting findings; its applicability depends on the study conditions.
- Hypothesis: a proposed explanation or effect that remains to be tested.
Why It Matters #
Which population provided the evidence on folic acid and stroke prevention? Check the detailed records for study conditions and use the literature map to compare other populations and outcomes.
What Was Studied #
20,702 Chinese adults with hypertension and no history of stroke or myocardial infarction. CSPPT: randomized, double-blind trial. Outcomes: First stroke[1]
What Was Found #
Incidence was 2.7% versus 3.4%; HR 0.79 (95% CI 0.68–0.93), lower in the folic acid combination group.[1]
What the Evidence Means #
Combined with antihypertensive medication in a population with a specific background folate status. The findings cannot be directly generalized to healthy people, other folate formulations or pregnancy.[1]
Comparing similar populations, formulations, durations and outcomes helps identify where findings agree and where they differ.
What We Can Learn #
Even with a positive large trial, do not omit its population and concomitant treatment.
What Remains Unknown #
Further questions include reproducibility across populations and formulations, and the long-term balance of benefits and harms. Use the literature map as a starting point for these questions.
LITERATURE MAP / 10 PAPERS
Compare papers by conditions and findings.
A literature map covering different populations, outcomes and formulations. Read alongside detailed records to avoid treating one trial as the conclusion for an entire ingredient.
Selected: 2026-09-21. Bibliographic information checked against Europe PMC / PubMed. Editorial selection considered major papers and a range of populations and questions. This is not a systematic search covering all recent research.
10 RECORDS
A dash marks fields outside the bibliographic record. Use detailed records to compare findings and design records to connect mechanisms.
No papers match. Change the search conditions.
The literature map is an index of research questions and references. Individual assessment of results, doses, funding and COI is limited to the detailed study records. Related reports from the same trial may be included; paper counts are not counts of independent trials.
Explore the research Study Records
Listed doses describe study conditions, not recommended intake.
Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China: the CSPPT randomized clinical trial.
PubMed 25771069DOI: 10.1001/jama.2015.2274
- Authors
- Huo Y, Li J, Qin X, Huang Y, Wang X, Gottesman RF, Tang G, Wang B, Chen D, He M, Fu J, Cai Y, Shi X, Zhang Y, Cui Y, Sun N, Li X, Cheng X, Wang J, Yang X, Yang T, Xiao C, Zhao G, Dong Q, Zhu D, Wang X, Ge J, Zhao L, Hu D, Liu L, Hou FF, CSPPT Investigators.
- Journal
- JAMA
- Publication year
- 2015
- Study design
- CSPPT: randomized, double-blind trial
- Participants
- 20,702 Chinese adults with hypertension and no history of stroke or myocardial infarction.
- Dose and intervention
- Enalapril 10 mg plus folic acid 0.8 mg/day versus enalapril 10 mg/day
- Duration
- Median 4.5 years
- Outcomes and their role in the study
- First stroke
- Findings
- Incidence was 2.7% versus 3.4%; HR 0.79 (95% CI 0.68–0.93), lower in the folic acid combination group.
- Limitations
- Combined with antihypertensive medication in a population with a specific background folate status. The findings cannot be directly generalized to healthy people, other folate formulations or pregnancy.
- Funding
- Joint support from Shenzhen AUSA Pharmed and public and other research funds in China.
- Conflict of Interest
- Huo reported AUSA nonfinancial support; Qin and B. Wang reported AUSA consulting fees. Several authors reported public research grants; no other disclosures were reported.
- Scope of source review
- The original abstract was checked for population, dose, duration and results; available source disclosures were checked separately. Any unverified disclosure details remain identified above.
Cite this page
LÍFSVARÐA. Folate: Which population provided the evidence on folic acid and stroke prevention? Version 1.1 / Updated 2026-10-24
https://lifsvarda.com/knowledge/folate/Edited by LÍFSVARÐA (product brand).Editorial policy
Safety and interactions
High supplemental folate can correct anemia caused by vitamin B12 deficiency without treating its neurological damage. Assess B12 status when clinically indicated. Methotrexate and antiepileptic medicines require individualized advice: folate use differs between cancer treatment and low-dose methotrexate therapy. Do not change prescribed treatment yourself.
Safety section reviewed: 2026-10-24.
Sources and updates
- Huo Y, Li J, Qin X, Huang Y, Wang X, Gottesman RF, Tang G, Wang B, Chen D, He M, Fu J, Cai Y, Shi X, Zhang Y, Cui Y, Sun N, Li X, Cheng X, Wang J, Yang X, Yang T, Xiao C, Zhao G, Dong Q, Zhu D, Wang X, Ge J, Zhao L, Hu D, Liu L, Hou FF, CSPPT Investigators. (2015). Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China: the CSPPT randomized clinical trial.The original abstract was checked for population, dose, duration and results; available source disclosures were checked separately. Any unverified disclosure details remain identified above.
First published: 2026-09-21 / Version 1.1. Updated 2026-09-23: Added a research comparison table and links to design records. Source notes identify the scope of verification when the full paper has not been reviewed. Research summaries and LÍFSVARÐA’s interpretation are distinguished.