Niacin: Power Over Cholesterol

Niacin is the oldest of today's commonly used cholesterol lowering agents. First prescribed for cholesterol issues as far back as 1955, niacin has demonstrated effectiveness in reducing both cardiovascular risk and mortality, and, in combination with other agents, it has been shown to stabilize or even reverse coronary vascular lesions. Mild niacin deficiency has also been shown to slow metabolism, causing decreased tolerance to cold.

When the biological significance of nicotinic acid was realized, it was thought appropriate to choose a name to dissociate it from nicotine, to avoid the perception that vitamins or niacin-rich food contains nicotine, or that cigarettes contain vitamins. The resulting name 'niacin' was derived from nicotinic acid + vitamin.

In a study that was published in the New England Journal of Medicine in November 2009, Extended Release Niacin (target dose was 2000 mg per day) performed much better than (ezetimide) Zetia (a cholesterol lowering drug) in improving Carotid Intima Media Thickness. Intima Media Thickness is a measurement of the thickness of artery walls, usually by ultrasound, to both detect the presence and to track the progression of atherosclerotic disease (hardening of the arteries) in humans. The study looked at people who were already on long-term cholesterol-lowering medication such as a statin and added either Niacin or ezetimide to their regimen.

To review the abstract of this study, please click here.

As demonstrated by this study, in the niacin group, the mean HDL ("good") cholesterol level increased by 18.4% (as compared to a 6% reduction in the ezetimide group) over the 14-month study period and there was a 13% reduction in LDL ("bad") cholesterol with a 17% reduction in triglyceride levels (compared to a 19.2% and 10% reduction respectively in the ezetimide group).

The incidence of major cardiovascular events was lower in the niacin group (1%) than in the ezetimide group (5%). There was an INCREASE in the carotid intima-media thickness (increased arterial plaquing) in the ezetimide group. As shown in this study and many previous studies, niacin has a long history as a nutrient to enhance cholesterol metabolism. Niacin in combination with a Mediterranean Diet and other specific nutritional support can effectively address cholesterol issues.

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