*By Dr Devan

Folate (vitamin B9) is not only about preventing anemia or supporting pregnancy; it plays a critical cardiovascular role as well.

How Folate Deficiency Affects the Heart

1. Homocysteine Accumulation

Folate, along with vitamins B12 and B6, is required to convert homocysteine → methionine.

Without folate, homocysteine levels rise (hyperhomocysteinemia).

High homocysteine damages the endothelium (inner lining of blood vessels), promotes clotting, and accelerates atherosclerosis.

2. Vascular Narrowing (Stenosis)

Chronic damage leads to plaque formation and vessel narrowing in coronary, carotid, and peripheral arteries.

This stenosis reduces blood flow, increasing risk of angina, stroke, and peripheral vascular disease.

3. Heart Blocks & Arrhythmias

Elevated homocysteine can also disrupt electrical conduction in the heart, predisposing to conduction blocks and arrhythmias.

Folate deficiency is linked to QT prolongation and abnormal ECG changes.

4. Congenital Heart Defects

In pregnancy, inadequate folate increases risk of structural heart defects in the fetus (e.g., septal defects, outflow tract stenosis), along with neural tube defects.

Clinical Evidence

Studies show that people with low folate levels have a significantly higher incidence of:

Coronary artery disease

Carotid artery stenosis

Heart block and arrhythmias

Supplementing folate (with B6 & B12) reduces homocysteine and lowers risk of cardiovascular events.

Key Takeaway

Inadequate folate → high homocysteine → endothelial injury → stenosis, blocks, and heart disease.

That’s why folate isn’t just a vitamin for pregnancy or blood health — it’s a cardio-protective nutrient vital for everyone.

*Dr Devan is a Mangaluru-based ENT specialist and author.

Hindusthan Samachar / Manohar Yadavatti