Study claimed that the using both enalapril and folic acid greatly reduce the risk of stroke in high blood patients. As always prevention is better than cure and nothing can top that.

According to a study appearing in JAMA, the combined use of the hypertension medication enalapril and folic acid, compared with enalapril alone, significantly reduced the risk of first stroke.

Stroke is the leading cause of death in China and second leading cause of death in the world. Primary prevention (prevention prior to a first episode) is crucial because 77% of strokes are first events. According to background information in the article, it is not certain if folic acid therapy is effective for primary prevention of stroke because of limited and inconsistent data.

The study included more than 20,000 adults in China with high blood pressure but without a history of stroke or heart attack. Dr. Yong Huo of Peking University First Hospital, Beijing, China, and colleagues randomly assigned the participants to receive daily treatment with a single-pill combination containing enalapril (10 mg) and folic acid (0.8 mg; n = 10,348), or a tablet containing enalapril alone (10 mg; n = 10,354).

For the study conducted from May 2008 to August 2013 in 32 communities in Jiangsu and Anhui provinces in China, participants were tested for variations in the MTHFR C677T gene (CC, CT, and TT genotypes) that may affect folate levels.

During a median treatment duration of 4.5 years, 282 participants (2.7%) in the enalapril-folic acid group experienced their first stroke, compared with 355 participants (3.4%) in the enalapril group. This stands for an absolute risk reduction of 0.7 percent and a relative risk reduction of 21 percent.

Significant reductions in the risk of ischemic stroke among participants in the enalapril-folic acid group (2.2 percent vs. 2.8 percent) and composite cardiovascular events (cardiovascular death, heart attack and stroke) (3.1 percent vs. 3.9 percent) was also observed.