Atherogenic dyslipidemia is a condition characterized by irregular LDL and HDL levels, which are often used as indicators of cardiovascular disease. Niacin has been shown to be effective in the maintenance of healthy lipid levels, which is crucial in averting severe complications of disease. However, a best possible pharmacologic dosage for achieving ideal levels has not been established.
Extended Release of Niacin
The November 2010 issue of "Vascular Health and Risk Management" published an article to evaluate the effects of extended-release niacin supplements on LDL levels in patients with irregularities in cholesterol concentrations. Patients with dyslipidemia, who were not previously receiving statin therapy, were recruited for the clinical trial. The participants received niacin at a dose of 1,000mg/day for four weeks and then 2,000mg/day for eight weeks. The researchers found that treatment produced a 52 percent decrease in plasma LDL level compared to a control group receiving no supplementation.
LDL Levels and Niacin
The association between elevated LDL levels and increased cardiovascular disease indicates that LDL is related to early onset of the disease. The December 2010 issue of the "European Heart Journal" included a study to critically evaluate therapeutic strategies using niacin to lower LDL levels. The authors advised that a particular component of LDL, called lipoprotein(a), be measured in patients at an intermediate or high risk of cardiovascular disease. To lower LDL levels, the authors recommended a treatment of niacin at 1 to 3g daily.
Dosage of Niacin
The October 2010 issue of "Minerva Cardioangiologia" included a study to evaluate the effects of extended release low-dose niacin supplement for the treatment of patients with irregular lipid profiles who did not respond to statin therapy alone. The authors conducted a clinical trial of patients receiving niacin dosages administrated at 250mg for the first two weeks, 500mg in the next two weeks and 750mg in the final four weeks. The study found significant increases of HDL and decreases of LDL, triglycerides and total cholesterol. The authors concluded that low-dose niacin treatment may be useful for improving lipid profiles, which they recommended for the prevention of cardiovascular disease.
Side Effects
An article appearing in the November 2010 issue of "Atherosclerosis" compared the effectiveness and tolerability of typical doses of niacin. The investigators conducted an eight-week dietary intervention in patients who had triglyceride levels of 150 to 499 mg/dL, HDL levels of less than 45 mg/dL and LDL levels of less than 130 mg/dL. The participants were randomly treated with extended-release niacin at a dose of 500mg for four weeks and 1,500mg the fifth through the ninth weeks or a placebo. The study found that the effects on HDL were similar in both groups, and niacin was effective at lowering LDL by almost 50 percent. However, the authors cautioned that niacin showed more frequent adverse side effects, including pruritus, or chronic itching, and flushing of the skin.
References
- "Vascular Health and Risk Management"; Combination of Niacin Extended-release and Simvastatin Results in a Less Atherogenic Lipid Profile Than Atorvastatin Monotherapy; W. Insull et al; November 2010
- "European Heart Journal"; Lipoprotein(a) as a Cardiovascular Risk Factor: Current Status; B. Nordersgaard et al; December 2010
- "Minerva Cardioangiologia"; Effects of Low-dose of Niacin Associated to Simvastatin in the Treatment of Mixed Dyslipidemia; B. Salgado et al; October 2010
- "Atherosclerosis"; Optimal Pharmacologic Approach to Patients with Hypertriglyceridemia and Low High-density Lipoprotein-cholesterol: Randomized Comparison of Fenofibrate 160 mg and Niacin 1,500 mg; J. Wi et al; November 2010
