The major risk factors for developing coronary artery disease include smoking, diabetes mellitus, high blood pressure, age, male gender, obesity, a family history of this disease and having a high level of low-density lipoprotein cholesterol in the bloodstream. Niacin and statin are two types of medications available to lower a high low-density lipoprotein cholesterol level.
Niacin
Niacin is vitamin B-3 and it also goes by the name of nicotinic acid. When taken in large amounts, it lowers the triglyceride and low-density lipoprotein levels. Relatively speaking, niacin lowers triglycerides more than low-density lipoproteins. It also interferes with the secretion of very low-density lipoproteins, explains Mary Malloy, M.D., co-director of the Adult Lipid Clinic at the University of California in "Greenspan's Basic & Clinical Endocrinology." Niacin increases the level of high-density lipoprotein, which has the nickname of "good cholesterol" because it takes cholesterol to the liver for removal.
Side Effects of Niacin
Some people who take niacin develop flushing on the face, the front and back of the body, but this happens more often with the immediate-release form after drinking alcohol, eating spicy foods, being in the sun or after aerobic exercise, writes Larry Johnson, M.D., Ph.D., attending physician at the Central Arkansas Veterans Healthcare System in "The Merck Manual for Healthcare Professionals." High doses can cause blurry vision, high blood glucose levels, abdominal pain, jaundice and gout attacks. Dr. Johnson advises that those with liver disorder refrain from taking the high dose form of niacin.
Statin
The name statin refers to lovastatin, atorvastatin, simvastatin, rosuvastatin, fluvastatin and pravastatin medications. The statin medications are HMG-CoA reductase inhibitors. They interfere with an enzyme, called HMG-CoA reductase, that the liver needs to make cholesterol. An enzyme is a protein the cells and tissues used to increase the time of a reaction. Because the statin medications interfere with this enzyme, the liver cannot make as much cholesterol, as explained in "Harrison's Principles of Internal Medicine" by Daniel Rader, M.D., professor of medicine at the University of Pennsylvania School of Medicine.
Side Effects of Statin
Some people who take statin medications develop three times the normal level of liver enzymes, a sign of liver damage, writes Mary Molloy, M.D. in "Basic & Clinical Pharmacology." The levels can be even higher in someone who abuses alcohol or has a liver disease. Some people may have an increase in an enzyme called creatine kinase, which can be a sign of muscle damage. However, many of the people with an increase in creatine kinase have been involved in a lot of physical activity.
References
- "Basic & Clinical Pharmacology"; Bertram Katzung, M.D., Ph.D., Susan Masters, Ph.D., Anthony Trevor, Ph.D.; 2009
- "Greenspan's Basic & Clinical Endocrinology"; David Gardner, M.D., Dolores Shoback, M.D.; 2007
- "Harrison's Principles of Internal Medicine"; Anthony Fauci, M.D., Dennis Kasper, M.D., Dan Longo, M.D. et al.; 2008
- The Merck Manual for Healthcare Professionals: Niacin
