In an study released by the New England Journal of Medicine (NEJM) on July 16, 2014, it has been determined that the benefits of niacin on preventing heart disease are not significant. It was further determined that the side effects of the niacin were significantly worse than previously expected for those taking statin drugs.
In a follow-up study of 25,673 high risk cardiac patients, taking niacin lowered LDL and increased HDL cholesterol, but the niacin did not reduce heart attacks, stroke or deaths due to heart attacks or strokes. Taking niacin did not reduce the need for coronary bypasses to restore blood flow in the heart.
Niacin increased the risk of diabetes, gastrointestinal issues, infections, musculoskeletal effects, and internal bleeding. The study noted that the increase in infection and internal bleeding were not expected.
The study period was 3.9 years, which is significantly longer than the period often used to get FDA approval of new drugs. The patients were pre-certified with regard to being able to take the niacin, and the patients were taking a statin drug. A secondary drug, laropiprant, was given with the niacin to reduce common adverse reactions to the niacin. The niacin dosage was 2 grams of extended release niacin. The placebo was a statin drug.
Among participants with atherosclerotic vascular disease, the addition of extended-release niacin–laropiprant to statin-based LDL cholesterol–lowering therapy did not significantly reduce the risk of major vascular events but did increase the risk of serious adverse events. (Funded by Merck and others; HPS2-THRIVE ClinicalTrials.gov number, NCT00461630.)
You can read the original study published by ClinicalTrials.gov, which is associated with the U.S. National Institute of Health. The study is titled Treatment of HDL to Reduce the Incidence of Vascular Events.
Niacin in combination with a statin drug has now been shown to increase fasting blood sugar and increases the risk for becoming diabetic. Diabetes increases the risk of heart disease, kidney failure and death. The FDA has now changed with warning labels on statin drug packaging to indicate these risks.
You can read an excellent article that talks about many of the key issues with regard to cholesterol monitoring and what the results define in terms of heart health. It is written for those of us that are not medical doctors. The author is Chris Keller MD. He sells a program to improve health. He provides some of his information without charge. The link to his article on cholesterol monitoring is free.
There are alternatives to statins that have been proven to be safe and effective in improving cholesterol values. A future article will talk about plant sterols and how they can improve heart health in combination with B vitamins and other natural supplements.
If you are taking niacin and you are at risk for diabetes or heart disease, you may want to reconsider whether you will continue taking niacin. If you are taking a statin, the study results indicate you should not be taking niacin at 2,000 mg per day.