Studies showing that the vitamins lower levels of a substance in the blood suspected of playing a role in the development of heart disease have prompted hundreds of thousands of heart patients in the developed world to take them.

However, the first large study of the question, presented Monday at a meeting of the European Society of Cardiology, found that although the supplements dramatically lowered the levels of homocysteine, they offered no heart protection.

"The message is clear here: Don't take folate or B-6 in the hope that it will stop you having a heart attack or stroke. If there was a real major effect, they would have seen it," said Dr. Peter Weissberg, medical director of the British Heart Foundation, which was not connected with the study.

Fortify Flour?

The findings are expected to stir the debate over whether homocysteine has any role at all in the development of heart disease. But they are unlikely to be the last word on the issue.

Eleven other studies testing the heart benefits of B vitamins in a total of nearly 50,000 people are underway. The aim is to build enough evidence to determine not only whether it would help if people took the supplements, but also whether it would be a good idea to fortify flour around the world with folic acid to boost heart health in developing countries and in other populations unlikely to supplement their diets.

At least one of those, which will follow 12,000 people for seven years, is expected to offer more definitive results in about 18 months from now, experts said.

20 Percent More Heart Attacks and Strokes

In the study, led by Dr. Kaare Harald Bonaa, a professor of cardiology at the University of Tromso in Norway, 4,749 heart attack survivors were divided into four groups.

In addition to standard heart medicines, one group took high dose vitamin B pills every day for three years. Another took high dose folic acid. A third group took both pills every day and the fourth group took fake pills.

There was no difference in the groups taking fake pills, vitamin B or folic acid when it came to new heart attacks or strokes. However, there were 20 percent more heart attacks and strokes among the group that took both pills.

Those who fared worst were patients who also had kidney problems, and those who reported they also take other vitamin supplements, the study found.

"This is the latest in a series of things that when tested in a scientific way don't actually pan out the way people expected," said Dr. Ray Gibbons, a professor of medicine at the Mayo Clinic who was not connected with the research.

(c) Associated Press
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