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Updated: May 31, 2026

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
Published on: April 27, 2016
Folic acid supplementation improves vascular function in professional dancers with endothelial dysfunction
Anne Z Hoch1, Paula Papanek, Aniko Szabo
1Department of Orthopaedic Surgery/Cardiovascular Center, Medical College of Wisconsin, Milwaukee, USA. azeni@mcw.edu
Objective:
To determine if folic acid supplementation improves vascular function (brachial artery flow-mediated dilation [FMD]) in professional dancers with known endothelial dysfunction.
Design:
Prospective cross-sectional study.
Setting:
Academic institution in the Midwestern United States.
Subjects:
Twenty-two professional ballet dancers volunteered for this study.
Main Outcome Measures:
Subjects completed a 3-day food record to determine caloric and micronutrient intake. Menstrual status was determined by interview and questionnaire. Endothelial function was determined as flow-induced vasodilation measured by high-frequency ultrasound of the brachial artery. A change in brachial diameter of <5% to hyperemic flow stimulus was defined a priori as endothelial dysfunction. Subjects with abnormal FMD took 10 mg of folic acid daily for 4 weeks, and FMD testing was then repeated. Serum whole blood was measured for folic acid levels before and after supplementation.
Results:
Sixty-four percent of dancers (n = 14) had abnormal brachial artery FMD (<5%) (mean ± standard deviation, 2.9% ± 1.5%). After 4 weeks of folic acid supplementation (10 mg/day), FMD improved in all the subjects (7.1% ± 2.3%; P < .0001).
Conclusions:
This study reveals that vascular endothelial function improves in dancers after supplementation with folic acid (10 mg/day) for at least 4 weeks. This finding may have clinically important implications for future cardiovascular disease risk prevention.
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