BEIJING – Folic acid, known in the United States for its link to preventing birth defects, was associated with reducing the risk of stroke in a study of 20,702 Chinese adults that appeared on-line March 15 in the Journal of the American Medical Association. The combined use of the medication enalapril and folic acid significantly reduced the risk of a person’s first stroke when compared to the use of enalapril alone.

Yong Hu, M.D., of Peking University First Hospital in Beijing was one of the study’s leaders. The randomized, double-blind clinical trial took place from May 19, 2008, to Aug. 24, 2013, in 32 communities in the Jiangsu and Anhui provinces.

The adults were between the ages of 45 and 75 at the beginning of the study. They had hypertension but not a history of stroke or myocardial infarction at the beginning of the study. People received either a single pill combination of 10 mg of enalapril and 0.8 mg of folic acid or a tablet containing 10 mg of enalapril. During a median treatment duration of 4.5 years, 282 people, or 2.7%, in the enalapril-folic acid group had a stroke, which compared to 355 people, or 3.4%, in the enalapril group.

The Shenzhen AUSA Pharmed Co. Ltd. supported the study as did national, municipal and private funding.

In the United States, there has been a 36% decline in the number of cases of neural tube birth defects since the U.S. Food and Drug Administration mandated folic acid fortification of enriched grains in 1998, according to the Grain Foods Foundation, Washington.