One day, Aunt Chen felt chest discomfort while dancing in the small square. The aunt beside her looked at her worriedly and said, "Oh, Aunt Chen, you have experienced this situation more than once recently. Do you want to see a doctor again?"

Aunt Chen is a retired person who often goes to the small square to dance and exercise.

One day, while Aunt Chen was dancing in a small square, felt chest discomfort . The aunt next to her looked at her worriedly and said: "Oh, Aunt Chen, you have experienced this situation more than once recently. Do you want to see a doctor again!"

Aunt Chen waved her hand, "It's okay, I'm having a bad habit, I'll take medicine to relieve myself."

It turns out that Aunt Chen's body is not healthy. Like most middle-aged and elderly people, they are always plagued by various diseases. Among them, Aunt Chen's High blood pressure has obvious symptoms .

Aunt Chen took the medicine and returned home after her body improved slightly, but she was still feeling a little uncomfortable. At the same time, Aunt Chen sat and chatted with her neighbor Xiaoyu as usual. As we chatted, we talked about Aunt Chen's high blood pressure. When Xiaoyu heard this, she hurriedly said to Aunt Chen: "Auntie, you can't do this. If you are still uncomfortable now, you have to go to the doctor to check your health!"

Aunt Chen thought it was reasonable and went to the attending doctor. After the doctor examined the aunt, he found Aunt Chen The content of homocysteine ​​ in plasma is significantly higher than that of . Aunt Chen prescribed folic acid tablets , and asked the aunt to take the blood-lowering drugs to supplement folic acid . Aunt Chen felt strange. She only knew that pregnant women needed to supplement folic acid, so she asked the doctor for the reason.

Doctor said: "Added women with folic acid can prevent congenital diseases. In addition to this, folic acid can also help lower blood pressure. Especially for you, not only high blood pressure, but the amount of homocysteine ​​in the body is also high. Supplementing some folic acid will help lower blood pressure."

Aunt Chen followed the doctor's instructions and after taking folic acid for a period of time, his health has indeed improved. After going to the hospital for a review, the homocysteine ​​value in Aunt Chen's blood returned to the normal range.

Someone is asking, why do you need folic acid when taking hypertension? Is it really useful? Next, let’s discuss the relationship between folic acid and hypertension on these issues.

1. What is folic acid?

Speaking of folic acid, many people basically stop at the "functional indication" in the instructions, such as folic acid deficiency and the prevention of megacute red blood cell anemia caused by pregnancy and breastfeeding women.

In fact, folic acid has a very wide effect, far more than the above. If you want to know the relationship between folic acid and hypertension, you must first understand the problems of , what folic acid is, its role , and other issues.

. The composition and source of folic acid

folic acid, also known as vitamin M or vitamin B9, is composed of pteridine, p-aminobenzoic acid and one or more glutamic acids, and is a collective name for a group of compounds.

folic acid widely sourced in , mainly distributed in green plants (such as spinach, broccoli, etc.), animal food (such as liver, egg yolk, etc.), fruit ( kiwi fruit , etc.), and yeast , etc.

. The role of folic acid

When the binding folic acid ingested by humans or animals from the above food is converted into free folic acid in the small intestinal mucosa, it is absorbed into the body participates in a number of physiological functions, such as participating in the metabolism of genetic material and protein , promoting animal growth, and improving body immunity. In addition to the above mentioned effects, folic acid has a significant role in the prevention and treatment of cardiovascular diseases. Studies have shown that folic acid has a preventive and therapeutic effect on various cardiovascular diseases [1].

Secondly, the preventive effect of Congenital heart disease . Regular supplementation of folic acid before and during the early stages of pregnancy is conducive to the development of fetal nervous system, preventing neural tube malformation of babies, and at the same time reducing the occurrence of hyperlipidemia in pregnant women. Therefore, folic acid supplementation almost runs through the entire pregnancy and even to lactation and .

In the above study, it also showed that folic acid can be used to treat hypertension, so how does it work?

2. The mechanism of action of folic acid to reduce hypertension

In fact, Folic acid cannot directly reduce hypertension .

is involved in the transformation and metabolism of some substances in the body, affecting the levels of certain substances to achieve different therapeutic effects. If you want to know how folic acid plays a role in lowering blood pressure, you might as well first briefly understand the metabolic process of folic acid in the body.

It can be seen from the folic acid metabolism process shown above that after a series of transformations in the body, folic acid forms 5-methyltetrahydrofolate, and under the action of synthetase, homocysteine ​​(Hcy) is converted into methionine, achieving the reduction of Hcy levels in plasma.

and Hcy is an intermediate product of methionine metabolism, which has been proven to be a vascular damaging amino acid. The high Hcy level of is closely related to diabetic cerebrovascular lesions, cardiovascular lesions, peripheral neuropathy, etc. , and has important reference value in clinical practice.

So how can reduce plasma Hcy levels help the treatment of hypertension?

"Analysis of epidemiological characteristics of hypertension complications" suggests that among the patients with primary hypertension in my country, about 75% of patients with are accompanied by an increase in Hcy . This type of special hypertension is clinically called H-type hypertension.

Among them, high Hcy levels will inhibit the mitochondrial function of vascular endothelial , stimulate the release of multiple active substances, damage autonomic nervous function, etc., thereby accelerating cardiovascular function damage. Studies have shown that high Hcy levels can cause changes in pathological such as myocardial hypertrophy in rats. It may be that the high Hcy levels of promote the body's oxidative stress response and lead to myocardial remodeling [2].

Therefore, in addition to the currently known vascular endothelial injury and inflammatory factors are related to the pathogenesis of hypertension, hypertension accompanied by increased Hcy has also attracted people's attention.

It is very worth noting that due to the long course of the disease in patients with hypertension, the high blood pressure increases the heart load and impact on blood vessels, and the high Hcy level promotes the formation of lesions such as myocardial hypertrophy, comprehensively increases the risk of cardiovascular disease complications . For example, lacunar cerebral infarction is a common disease caused by hypertension and high Hcy level [3].

The above is also one of the reasons why H-type hypertension patients cannot achieve good therapeutic effects when using general antihypertensive drugs. Therefore, in clinical practice, usually supplement with low doses of folic acid to assist in the treatment of , such as enalapril maleate folic acid tablets. Experimental research has proved that antihypertensive drugs combined with folic acid tablets can indeed achieve good therapeutic effects.

treatment of H-type hypertension is performed by antihypertensive drugs combined with small doses of folic acid. What if it is a larger dose of folic acid? What side effects will it cause?

3. Side effects of folic acid

For patients, how to take medicine is also the top priority. Most people are more afraid of the side effects of drugs, including some news reports, such as some drugs seriously damage some physiological functions and even cause death.

Among them, folic acid has fewer side effects. Generally, the premise of side effects is that is excessively taken . The side effects mainly reflect the following three aspects:

) Gastrointestinal reaction

As a necessary substance in the human body, there are many ways to participate in physiological functions. Among them, folic acid has the ability to promote the absorption of sodium ions , water and glucose in the small intestine mucosa, which is an important way to treat diarrhea.

Therefore, when folic acid is excessive, it will cause sodium ions and water retention, causing gastrointestinal reaction symptoms such as anorexia, nausea, and bloating.

) Damage to the nervous system

Excessive folic acid will cause damage to the nervous system, and folic acid deficiency will also cause a variety of neuropsychiatric symptoms, such as insomnia, depression, etc. Taking an appropriate amount of folic acid can relieve these symptoms.

But it is worth noting that vitamin B12 deficiency is very similar to the symptoms caused by folic acid deficiency. When excessive folic acid is consumed, the adverse reactions caused may mask mental symptoms such as depression caused by vitamin B12, resulting in severe damage to the nervous system. And this is easy to overlook.

) Zinc deficiency

Research has proved that Folic acid and zinc have mutual inhibitory effects. When folic acid is deficient, the zinc value of red blood cells will be relatively high. This discovery is particularly obvious in patients with megacute erythrocytic anemia; when zinc is deficient, the content of folic acid will be relatively high. The mechanism of mutual inhibition is likely to be that the two form an insoluble folate-zinc complex, which affects each other's metabolism.

Therefore, excessive folic acid will lead to a deficiency of zinc. As one of the important trace elements in the human body, zinc participates in important physiological functions of the human body, especially plays a very important role in the development of the fetus. The deficiency of zinc can easily lead to fetal development delay .

or above also requires pregnant and breastfeeding women to consume appropriate amounts of folic acid when supplementing with folic acid, so as not only prevent and reduce the occurrence of congenital diseases, but also prevent fetal developmental delay and harm to women themselves.

) The urine is yellowed

The urine of healthy people is generally shown as a light yellow liquid. When medication is taken or urinary tract infection and other damages occur, the color of the urine may change. Folic acid is one of them.

Because folic acid contains B vitamins, and B vitamins are rich in riboflavin, and The human body cannot fully absorb riboflavin , and it will dissolve in the urine after the kidneys excrete, so it is manifested as yellowing of urine. For healthy people, you can usually return the color of the urine to normal by drinking water frequently and urinating more.

The probability of side effects caused by small doses of folic acid is very small, and side effects that occur in normal people are often easy to heal themselves. But this means that is it okay to take in small doses and long-term use of ?

4. Can folic acid be taken for a long time? Whether a class I of drugs such as

can be taken for a long time depends on the characteristics of the drug itself and the patient's own condition. When a drug has slow metabolism in some humans and is prone to accumulation, it is generally not recommended to take this drug for a long time .

Although some patients must take medications for life, such as insulin resistance to diabetes and most patients with hypertension need to take the corresponding medications for a long time. Doctors usually recommend re-examination for a period of time to observe the changes in various indicators in the patient's body.

High-term medication usually causes the accumulation of drugs in the body. Similarly, long-term use of folic acid will also cause accumulation, especially in some patients, folic acid has weak metabolic function .The side effects caused by accumulation in the body are similar to those of excessive use.

However, in some studies, taking folic acid in a small dose for a long time can also achieve the effect of reducing high Hcy levels. Of course, the premise is that is not affected by a variety of factors, such as gender, age, polymorphisms of related metabolic genes, smoking, etc.

Therefore, long-term use of folic acid will still be affected by many unstable factors, and the safety of long-term use of drugs cannot be ensured. If you need to take folic acid for a long time, must be taken under the guidance of a doctor.

Folic acid can participate in the treatment of hypertension by regulating homocysteine ​​(Hcy) levels, reducing the risk of hypertension and other cardiovascular diseases. For example, patients with hypertension and excessive homocysteine ​​levels can achieve good treatment results.

However, the intake of folic acid should not be too much. Although a larger dose can also achieve the therapeutic effect, it is also easy to cause adverse reactions; and long-term use of folic acid needs to be determined and adjusted according to the situation of different patients. Do not take it blindly and take the medicine according to the doctor's prescription.

References:

[1] Zhan Yike, Qiu Xiaoqiang . Research progress of folic acid in cardiovascular disease prevention and treatment [J]. Medical Guide, 2014, 33(02): 224-227.

[2] Zhang Zhimin, Zhao Lianyou, Lu Fan, Zou Qing, Li Xue, Ding Lu, Wei Congying. High homocysteine ​​on cardiomyocytes of hypertensive rats GRP7 8 and CHOP expression and left ventricular hypertrophy [J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2014, 6(02): 223-226+228.

[3] Chen Jing, Li Binglong. Effects of folic acid dose on carotid artery sclerosis and cerebral ischemia in patients with hypertension and lacunar cerebral infarction [J]. Practical Clinical Integration of Traditional Chinese and Western Medicine , 2022, 22(10): 51-53.