From The November 2001 Issue of Nutrition Science News

Niacin Helps Hearts

by Anthony Almada

Niacin (nicotinic acid), a B vitamin, is one of the oldest drugs used to treat high blood-cholesterol levels. Unlike its nonflushing counterpart, niacinamide, niacin displays potent LDL cholesterol- and triglyceride-lowering effects and HDL cholesterol-elevating effects. Niacin has also been shown to help reverse hardening of the arteries and to decrease the incidence of heart disease and its associated deaths, qualities that distinguish it from other dietary supplements.^1-4

Results of a recent study suggest that 2.1 g/day niacin can produce cardioprotective effects in people with heart disease risk factors, including high triglycerides, low HDL cholesterol, and an abundance of smaller, more dense LDL cholesterol.⁵ Niacin has not been used more often in cardiovascular treatment because of the high doses needed to reverse the disease (in excess of 1,000 mg/day), and the sometimes uncomfortable skin flushing that follows 15-60 minutes after ingestion. Time-released niacin formulations can be gradually increased daily up to a maximum tolerable dose. Taking niacin with one baby aspirin before a meal can reduce the flushing effect. Patients should consult with a physician before implementing high-dose niacin therapy.

Anthony Almada is a nutritional and exercise biochemist and has collaborated on more than 50 university-based clinical trials. He is the co-founder of EAS and founder and chief scientific officer of IMAGINutrition.

References

1. Mack WJ, et al. One-year reduction and longitudinal analysis of carotid intima-media thickness associated with colestipol/niacin therapy. Stroke 1993; 24:1779-83.

2. Nikkila EA, et al. Prevention of progression of coronary atherosclerosis by treatment of hyperlipidaemia: a seven-year prospective angiographic study. Br Med J 1984;289:220-3.

3. Canner PL, et al. Fifteen-year mortality in coronary drug project patients: long-term benefit with niacin. J Am Coll Cardiol 1986;8:1245-55.

4. Pritzker LB. Do lipid lowering drugs reduce the risk of coronary heart disease? Crit Rev Clin Lab Sci 1998;35:603-21.

5. McKenney JM, et al. Effect of niacin and atorvastatin on lipoprotein subclasses in patients with atherogenic dyslipidemia. Am J Cardiol 2001;88:270-4.