UMaine, University of Arkansas researchers collaborate to identify medical foods that lower homocysteine and blood pressure
Ten million individuals in the United States have drug-resistant hypertension, defined as hypertension not effectively managed with three or more antihypertensive drugs, including a diuretic, according to researchers.
In a December 2022 editorial in the Journal of Clinical Hypertension, Merrill F. Elias from the University of Maine and Dr. Craig J. Brown from the University of Arkansas for Medical Sciences advocate for lowering homocysteine as a means of lowering blood pressure and as a tool for better managing of treatment-resistant hypertension. They also identify three FDA-approved medical foods that achieve the goal of a single product, which may be used for lowering homocysteine and stroke risk, and may also further lower blood pressure.
Homocysteine is an amino acid with significant toxicity. Vitamins B2, B6, B12 and folate convert homocysteine into more beneficial substances for use in the body. High levels of homocysteine (≥ 10µmol/L) are observed in persons with deficiencies of these vitamins or inherited impairments of their vitamin metabolism.
Untreated, high levels of homocysteine increase the risk for cardiovascular disease, dementia, kidney disease, memory loss and early death.
In their editorial, Elias, UMaine professor of psychology and director of the Maine Syracuse Longitudinal Study (MSLS), and Brown, adjunct professor of ophthalmology at the University of Arkansas for Medical Sciences, review the literature indicating that administration of vitamin B2, vitamin B6, L-methylfolate, and vitamin B12 lower homocysteine, and the risk of stroke. However, an optimal combination is not specified in the literature for safety and effectiveness, which could be combined into a single pill or capsule.
A single pill or capsule is important to patients and physicians who may not be well trained in nutrition or who may not have time to sort through multiple separate vitamins. Moreover, patients taking multiple drugs (e.g., in treatment-resistant hypertension) would be helped if the number of pills to be taken daily could be minimized.
The issue has now been addressed in the paper by Elias and Brown in the Journal of Clinical Hypertension: “Medical foods for lowering of homocysteine in hypertensive patients.” The researchers identify three FDA-approved medical foods — Metanx, Cerefolin NAC, and Ocufolin — that achieve the goal of a single product, which may be used for lowering homocysteine and stroke risk, and may also further lower blood pressure.
Medical Foods are foods specially formulated and intended for the dietary management of a disease that has distinctive nutritional needs that cannot be met by normal diet alone.
Metanx, Cerefolin NAC, and Ocufolin are all proven to lower homocysteine. Ocufolin has the most extensive combination of vitamins and antioxidants that play roles in the reduction of blood pressure. Thus, Elias, who is also emeritus cooperating professor in the UMaine Graduate School of Biomedical Sciences and Engineering, and Brown say, physicians and health care providers have prescribable products at hand that can be used to lower homocysteine, stroke risk, and further lower BP. In addition, studies have shown that hypertensive patients receiving extra folate have a 12% reduction in stroke.
More information about homocysteine as a risk factor for cardiovascular disease and lowered cognition is available at MedlinePlus, American Journal of Hypertension and Journal of Internal Medicine.
Contact: Merrill Elias, mfelias@maine.edu