Serum Folate and Risk of Fatal Coronary Heart Disease

Abstract
Objective. —To assess the relationship between serum folate level and the risk of fatal coronary heart disease (CHD) among men and women. Design. —Retrospective cohort study with serum folate levels measured from September 1970 to December 1972, with follow-up through 1985. Setting. —Participants in the Nutrition Canada Survey. Participants. —A total of 5056 Canadian men and women aged 35 to 79 years with no history of self-reported CHD. Main Outcome Measure. —Fifteen-year CHD mortality. Results. —A total of 165 CHD deaths were observed. We found a statistically significant association between serum folate level and risk of fatal CHD, with rate ratios for individuals in the lowest serum folate level category (13.6 nmol/L [6 ng/mL]) of 1.69 (95% confidence interval, 1.10-2.61). Conclusions. —These data indicate that low serum folate levels are associated with an increased risk of fatal CHD. (JAMA. 1996;275:1893-1896)