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Niacin Does Not Reduce Stroke Or Heart Attack Risk, Trial Ended 18 Months Early

August 06, 2017

Niacin, also known as nicotinic acid, vitamin B3 or vitamin PP does not protect patients with vascular and heart disease from stroke or heart attack. A clinical trial which compared combination niacin with a statin versus statins alone had to be ended 18 months early, according to Abbot Laboratories and the National Heart, Lung and Blood Institute.

Niacin is an organic compound with the formula C6H5NO2. It is considered as one of the 48 essential human nutrients (depending on the definition used).

The AIM-HIGH trail wanted to determine whether patients with vascular and heart disease might benefit from having niacin added to their statin therapy. Niacin is known to raise the levels of good cholesterol - HDL - and scientists thought this would provide patients with some protection from stroke or heart attack. Surprisingly, this did not occur.

The trial involved 3,414 patients who were at risk of suffering a cardiovascular event, such as a heart attack or stroke; they were all from the USA and Canada. 1,718 of them received a statin plus high-dose extended release niacin, while the rest (1,696) continued on their statin only treatment.

Although those on the combination niacin treatment did eventually have higher HDL cholesterol and lower blood triglyceride levels, their risk of heart attack or stroke did not improve. In fact, it got worse - 1.6% of the niacin group had a cardiovascular event compared to 0.7% of those on statins alone.

The researchers admitted that the results surprised them. The combination treatment group also had the same risk of being hospitalized as those just on statins.

This clinical study has raised more questions than answers, experts are now saying. How can a drug which is known to raise HDL (good cholesterol) levels by between 10% and 30% not improve outcomes? HDL is supposed to help clear plaque from the arteries. Most individuals with naturally high HDL levels are known to have a much lower risk of heart attack or stroke. All this study tells us so far is that heart disease is much more complicated than we had thought.

Although this might not be good news for patients at risk of a cardiovascular event, dropping niacin from their treatment may have one advantage. It is not a nice drug to take, because it commonly causes unpleasant headaches and flushing.