ABSTRACT Background: We recently reported that the elevated blood pressure (BP) observed in patients with cardiovascular disease who are... » More

ABSTRACT

Background: We recently reported that the elevated blood pressure

(BP) observed in patients with cardiovascular disease who are homozygous

for the 677C/T polymorphism (TT genotype) in the gene

encoding methylenetetrahydrofolate reductase (MTHFR) was responsive

to supplementation with riboflavin—the cofactor for MTHFR.

Objective: The objective was to investigate the effect of riboflavin

on BP targeted at patients with the TT genotype 4 y after initial

investigation, during which time major changes in the clinical

guidelines for antihypertensive therapy were introduced.

Design: A total of 83 patients (representing all 3 genotypes) who

participated in a placebo-controlled riboflavin intervention for 16

wk in 2004 agreed to take part. Nested within this follow-up, those

with the TT genotype (n = 31) proceeded to intervention with riboflavin

(1.6 mg/d for 16 wk) or placebo, conducted in a crossover

style whereby the 2004 treatment groups were reversed.

Results: At follow-up in 2008, as in 2004, patients with the TT

genotype had higher systolic BP (P , 0.01), with a nonsignificant

trend noted for higher diastolic BP (P = 0.051). Despite the marked

changes in antihypertensive therapy that had occurred, BP remained

unchanged in patients with the TT genotype at the time of followup.

Riboflavin supplementation (administered in 2004 and 2008)

produced an overall decrease in systolic (29.2 6 12.8 mm Hg;

P = 0.001) and diastolic (26.0 6 9.9 mm Hg; P = 0.003) BP.

Conclusions: Optimizing riboflavin status offers a low-cost targeted

strategy for managing elevated BP in this genetically at-risk group.

These findings, if confirmed in the general population, could have

important implications for the prevention of hypertension. Am J

Clin Nutr doi: 10.3945/ajcn.111.026245.

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