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May 12, 2004

Vitamin Supplementation and Risk of Stroke

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(18):2191-2192. doi:10.1001/jama.291.18.2191-a

To the Editor: In their randomized controlled trial, Dr Toole and colleagues1 found that a high-dose formulation of pyridoxine, cobalamin, and folic acid led to moderate reduction of total homocysteine levels after nondisabling cerebral infarction, but this did not translate into any benefit in terms of clinical end points. Nonetheless, the authors also found that, across all patients, total homocysteine levels were related to risk of clinical events, and thus they concluded that serum homocysteine is a marker, rather than a cause of vascular disease.

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