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A new study offers hope that the risk of a common heart medication could be reduced simply by taking B vitamins as well.
A common heart medication called calcium channel blockers is used to treat chest pain and high blood pressure.1 However, studies show these drugs may also increase the risk of death and other cardiovascular harms like heart failure.2,3 Researchers now report that taking B vitamins like folic acid and vitamin B12 could eliminate most of this risk.4
The study included nearly 4,000 patients undergoing cardiac testing for suspected coronary artery disease.4 About 23% were taking calcium channel blockers, while 62% received B vitamin treatment as part of the trial.4 After a decade, patients taking calcium channel blockers had over a 30% higher risk of death compared to non-users.4 However, this risk seemed erased in patients also receiving B vitamins.4
Why would B vitamins make these drugs safer? Calcium channel blockers may raise homocysteine, an amino acid linked to cardiovascular disease.5 They also increase sympathetic nervous activation,6 inflammation,7 and clotting8 while reducing fibrinolysis.9 B vitamin treatment lowers homocysteine10 and helps mitigate these other effects.11-14 Therefore, it is biologically plausible that B vitamin supplementation could eliminate much of the risk associated with calcium channel blockers.
These results have important implications for natural healing. Nutritional therapy may reduce the risk of medications rather than simply replace them.Heart disease patients taking calcium channel blockers could consider adding a good B complex supplement.
More research is still needed. This was not a controlled trial, so there could be residual bias affecting the findings. Additionally, while safe in moderate doses, synthetic high folic acid intake may have risks like cancer (in distinction to naturally occurring folate found in chlorophyll rich foods, which have no known adverse effects).15 Still, this research provides initial evidence of B vitamins' protective effects against a common heart drug. Nutritional therapy may not only complement conventional treatments, but make them safer as well.
References
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2. Furberg, C.D., Psaty, B.M. & Meyer, J.V. Nifedipine. Dose-related increase in mortality in patients with coronary heart disease. Circulation 92, 1326-1331 (1995).
3. Goldbourt, U. et al. Early administration of nifedipine in suspected acute myocardial infarction. The Secondary Prevention Reinfarction Israel Nifedipine Trial 2 Study. Arch. Intern. Med. 153, 345-353 (1993).
4. Dhar, I. et al. B-vitamin Treatment Modifies the Mortality Risk Associated with Calcium Channel Blockers in Patients with Suspected Stable Angina Pectoris: A Prospective Cohort Study. Am. J. Clin. Nutr. (2023) doi:10.1016/j.ajcnut.2023.04.
5. Tatar, L.E., Alderman, M.H. & Factor, S.M. Serum homocysteine in men with controlled hypertension taking dihydropyridine calcium channel blockers. J. Biol. Med. 19, 33-37 (2002).
6. Grossman, E. & Messerli, F.H. Effect of calcium antagonists on sympathetic activity. Eur Heart J 19, F27-F31 (1998).
7. Rödler, S., Roth, M., Nauck, M. & Tamm, M. Ca(2þ)-channel blockers modulate the expression of interleukin-6 and interleukin-8 genes in human vascular smooth muscle cells. J. Mol. Cell. Cardiol. 27, 2295-2302 (1995).
8. Sakata, K. et al. Differential effects of enalapril and nitrendipine on the fibrinolytic system in essential hypertension. Am. Heart J. 137, 1094-1099 (1999).
9. Pahor, M. et al. Fosinopril versus amlodipine comparative treatments study: a randomized trial to assess effects on plasminogen activator inhibitor-1. Circulation 105, 457-461 (2002).
10. Mayer Jr., O. et al. Treatment of hyperhomocysteinemia with folic acid: effects on homocysteine levels, coagulation status, and oxidative stress markers. J. Cardiovasc. Pharmacol. 39, 851-857 (2002).
11. Manrique, J. et al. Folic acid and B vitamins improve hyperhomocysteinemia-induced cardiovascular risk profile in renal transplant recipients. J. Thromb. Haemost. 5, 1072-1076 (2007).
12. Shu, X.J. et al. Different doses of folic acid and vitamin B12 to treat rabbits with deep venous thrombosis and hyperhomocysteinemia. Exp. Ther. Med. 15, 2874-2878 (2018).
13. Paulose, C.S., Dakshinamurti, K. & Packer, S. Sympathetic stimulation and hypertension in the pyridoxine-deficient adult rat. Hypertension 11, 387-391 (1988).
14. Ebbing, M. et al. Mortality and cardiovascular events in patients treated with homocysteine-lowering B vitamins after coronary angiography: a randomized controlled trial. JAMA 300, 795-804 (2008).
15. Ebbing, M. et al. Mortality and cardiovascular events in patients treated with homocysteine-lowering B vitamins after coronary angiography: a randomized controlled trial. JAMA 300, 795-804 (2008).
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