Depletes Folic Acid. This medication is commonly used for Hypertension
This drug is a comprehensive combination of a angiotensin receptor blocker, calcium channel blocker, and thiazide diuretic. Calcium channel blockers (CCBs), particularly nifedipine, can cause gum tissue overgrowth (gingival hyperplasia) in both men and women. Studies suggest a dose-dependent link with CCBs potentially doubling the risk. Studies also confirm a link between CCB use (like amlodipine and nifedipine) and gingival hyperplasia, even beyond factors like poor hygiene. Research suggests impaired folate uptake in gum tissue might be another key contributor. Supplementation with folate to help protect against CCB-induced hyperplasia may be beneficial. Studies indicate thiazide diuretics may act like folate antagonists, potentially leading to folate deficiency. Research suggests long-term use (over six months) can significantly decrease blood folate levels while increasing homocysteine, a potentially harmful amino acid linked to vascular disease. Folate supplementation should be considered while on thiazide diuretics.
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Folate (.2mg as L-5-Methylfolate) — 0.34 DFE
Low folate status contributes to elevated homocysteine, a metabolite that has been associated with endothelial dysfunction, arterial stiffness, and a higher risk of stroke and coronary heart disease. Large observational studies consistently show that individuals with higher homocysteine levels have greater rates of cardiovascular events, and folate intake is one of the key nutritional determinants of homocysteine. Clinically, folic acid supplementation (often combined with vitamins B6 and B12) can lower homocysteine and appears to modestly reduce stroke risk in some populations, making the identification and correction of folate deficiency an important part of broader cardiovascular risk reduction.
Folate deficiency in the periconceptional period significantly increases the risk of neural tube defects (NTDs) such as spina bifida and anencephaly, because adequate folate is required for proper closure of the embryonic neural tube in the first month of pregnancy. Large observational datasets and randomized trials have shown that appropriate folic acid supplementation before conception and in early pregnancy can reduce NTD risk by roughly 50–70% in the general population, with even greater risk reduction in women with a prior NTD‑affected pregnancy. The practical implication is that all women of childbearing potential, not just those actively planning pregnancy, are typically advised to maintain adequate daily folic acid intake so that red‑cell folate stores are sufficient well before conception occurs.