To the Editor: Despite the negative outcomes of the Women's Antioxidant and Folic Acid Cardiovascular Study (WAFACS) by Dr Albert and colleagues1 and the VISP, HOPE-2, NORVIT, CHAOS-2, and WENBIT trials,2 we believe that the homocysteine hypothesis is by no means dead. Although pharmacological intervention with B vitamin supplementation does not seem to provide beneficial cardiovascular outcomes, nutritional intervention with fortification of cereal grains with folic acid may have a significant long-term effect on primary cardiovascular prevention.
Ntaios G, Savopoulos C, Karamitsos D. Effect of Folic Acid and B Vitamins on Cardiovascular Disease in Women. JAMA. 2008;300(12):1409-1410. doi:10.1001/jama.300.12.1409-a