{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T04:03:11Z","timestamp":1768968191144,"version":"3.49.0"},"reference-count":51,"publisher":"American Physiological Society","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American Journal of Physiology-Regulatory, Integrative and Comparative Physiology"],"published-print":{"date-parts":[[2018,10,1]]},"abstract":"<jats:p> Heart failure (HF) patients are susceptible to heat strain during exercise, secondary to blunted skin blood flow (SkBF) responses, which may be explained by impaired nitric oxide (NO)-dependent vasodilation. Folic acid improves vascular endothelial function and SkBF through NO-dependent mechanisms in healthy older individuals and patients with cardiovascular disease. We examined the effect of folic acid supplementation (5 mg\/day for 6 wk) on vascular function [brachial artery flow-mediated dilation (FMD)] and SkBF responses [cutaneous vascular conductance (CVC)] during 60 min of exercise at a fixed metabolic heat production (300 \u1e86<jats:sub>Hprod<\/jats:sub>) in a 30\u00b0C environment in 10 patients with HF (New York Heart Association Class I\u2013II) and 10 healthy controls (CON). Serum folic acid concentration increased in HF [preintervention (pre): 1.4\u2009\u00b1\u20090.2; postintervention (post): 8.9\u2009\u00b1\u20096.7 ng\/ml, P\u2009= 0.01] and CON (pre: 1.3\u2009\u00b1\u20090.6; post: 5.2\u2009\u00b1\u20094.9 ng\/ml, P\u2009= 0.03). FMD improved by 2.1\u2009\u00b1\u20091.3% in HF ( P &lt; 0.01), but no change was observed in CON postintervention ( P\u2009= 0.20). During exercise, the external workload performed on the cycle ergometer to attain the fixed level of heat production for exercise was similar between groups (HF: 60\u2009\u00b1\u200913; CON: 65\u2009\u00b1\u200920 external workload, P\u2009= 0.52). Increases in CVC during exercise were similar in HF (pre: 0.89\u2009\u00b1\u20090.43; post: 0.83\u2009\u00b1\u20090.45 au\/mmHg, P\u2009= 0.80) and CON (pre: 2.01\u2009\u00b1\u20090.79; post: 2.03\u2009\u00b1\u20090.72 au\/mmHg, P\u2009= 0.73), although the values were consistently lower in HF for both pre- and postintervention measurement intervals ( P &lt; 0.05). These findings demonstrate that folic acid improves vascular endothelial function in patients with HF but does not enhance SkBF during exercise at a fixed metabolic heat production in a warm environment. <\/jats:p>","DOI":"10.1152\/ajpregu.00132.2018","type":"journal-article","created":{"date-parts":[[2018,7,5]],"date-time":"2018-07-05T14:14:28Z","timestamp":1530800068000},"page":"R810-R819","source":"Crossref","is-referenced-by-count":7,"title":["Folic acid supplementation improves vascular endothelial function, yet not skin blood flow during exercise in the heat, in patients with heart failure"],"prefix":"10.1152","volume":"315","author":[{"given":"Bryce N.","family":"Balmain","sequence":"first","affiliation":[{"name":"School of Allied Health Sciences, Griffith University, Gold Coast, 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