Sarah Lewis

NTR 313
3/25/2009
Niacin and Cardiovascular Disease
Introduction:
Vitamin B3, also termed Niacin, is an essential vitamin in the B-complex that is a
major component in supporting cardiovascular health by controlling and regulating
cholesterol levels. This in turn helps to reduce the risk of coronary artery disease (CAD)
(1). A research study at Stanford University confirmed that there are several ways in
which Niacin helps prevent this risk (2). The supplementation of Niacin, or Nicotinic
Acid, into a person’s diet helps to elevate high-density lipoprotein (HDL) cholesterol and
HDL² levels thus reduces CAD risk (2). Along with elevations to favorable cholesterol
levels, Niacin works further to decrease low-density lipoprotein (LDL) cholesterol,
VLDL cholesterol, triglycerides, and lipoprotein A levels which also help decrease risk
for CAD (1). Secondly, while flushing is one of the major side-effects that discourages
the use of Niacin, a new extended-release Niacin called Niaspan has been formulated (4).
It has been proven that when administered once a day, this extended-release Niacin works
to reduce the cause of flushing while avoiding the scare of hepatotoxicity (3). Niaspan
has effectively provided patients with a safe way to help protect themselves from CAD.

Objective:
To prove that Niacin is an essential mineral that supports cardiovascular health.
With proper supplementation, Niacin works to regulate proper levels of cholesterol and
triglyceride which promotes regression of CAD and total mortality (1). Also, to prove
that Niaspan, the extended-release form, is a safe and effective form of Niacin that
decreases the side-effects of flushing while eliminating the risk of elevated hepatotoxicity
(3).

Materials and Methods:

The effect of Nicotinic acid on cholesterol levels was studied in a group of 24
patients with Familial Combined Hyperlipidemia (FCH). The patients were randomly
assigned to a group. One group was given a placebo every day while the other group was
give 1,500 mg of Nicotinic Acid per day (2). Mean baseline levels and changes in
plasma lipoprotein concentrations were measured and compared (2). The second
experiment tested the hepatic enzyme levels in diabetic patients who were given the
extended-release Niacin, Niaspan, as opposed to either the slowing-absorption or
sustained-release forms to reduce flushing side-effects.

Results:
Nicotinic Acid increased HDL levels while lowering LDL, VLDL, and
triglyceride levels. Niaspan showed only mild, insignificant increases in hepatic enzyme
levels, while proved no threat to hepatotoxicity.

Summary and Discussion:

The research on Niacin establishes that it is a mineral that plays an important role
in cardiovascular health and in reducing a patients risk for coronary artery disease (2).
Supplementation of Niacin increase HDL levels along with reducing LDL, VLDL, and
triglyceride levels (1). Niaspan reduces flushing while avoiding hepatotoxicity (3).
 References

1. Superko, R.H., Garrett, B.C., King, S.B., Momary, K.M., Chronos, N.A., Wood,
P.D. (2009) Effect of Combination Nicotinic Acid and Gemfibrozil Treatment on
IDL, and Subclasses of LDL and HDL in Patients With Combined
Hyperlipidemia: The American Journal of Cardiology. 103: 387-392.

2. Tavintharan, S., Kashyap, M.L., (2001) The Benefits of Niacin in Atherosclerosis:

Current Science Inc. 3:74-82.

3. Guyton, J.R. (2004) Extended-release Niacin for Modifying the Lipoprotein

Profile: Expert Opin Pharmacother. 5:1385-1398.

4. Morgan, J.M., Capuzzi, D.M., Guyton, J.R. (1998) A New Extended-release

Niacin (Niaspan): efficacy, tolerability, and safety in hypercholesterolemic
patients: AM J Cardiol. 82:29U-34U.