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Dec 20, 2011

Niacin and Statin Therapy to Lower Cardiovascular Risk

Lowering bad cholesterol is important, but don’t forget about raising your good cholesterol.

Cholesterol is a waxy substance found in fat, which in high doses can build up in the arteries, blocking blood flow and increasing risk for heart attack and stroke. Fortunately, drugs called statins have been developed that block the formation of cholesterol, slowing the progression of heart disease and sometimes even reversing plaque build-up. These drugs are extremely effective in lowering low-density lipoprotein (LDL) cholesterol and reducing risk for heart attack and stroke.

However, not all cholesterol is considered bad. High-density lipoprotein (HDL) cholesterol, known as “good cholesterol” can actually help get rid of the “bad cholesterol” that clogs arteries. There are many ways to help increase HDL cholesterol, such as taking niacin — a B vitamin that helps raise good cholesterol up to 35 percent. So although it is important to lower bad cholesterol, it can be equally as important to take steps toward raising good cholesterol to improve heart health.

Accordingly, researchers studied whether patients with heart disease taking statins to lower their bad cholesterol would also benefit from taking niacin to help raise good cholesterol. This study, published by the New England Journal of Medicine, included more than 3,400 patients — half of whom received niacin in addition to statins, and half of whom received statins only. After following patients for three years, researchers found that although patients taking niacin saw significant improvements in good cholesterol and overall cholesterol levels, this did not translate into fewer adverse outcomes, such as heart attack, stroke and death. Although further research is needed around the use of niacin in combination with statins to improve outcomes, statins alone will remain the standard treatment to lower cholesterol in patients with existing heart disease.

Questions for You to Consider

  • Can I lower my cholesterol without medication?

  • Yes. There are a variety of lifestyle changes that can help lower cholesterol, including exercise, maintaining a healthy weight, eating healthy and quitting smoking (if a smoker). However, lifestyle changes may not be enough to lower cholesterol for some, especially those with a family history of high cholesterol.
  • How do I know if I have high cholesterol?

  • High cholesterol has no symptoms, so it is important to have your cholesterol tested regularly by your doctor. Based on results from a lipid panel, your doctor can tell you if you have regular, borderline or high cholesterol levels.

Related

Benefits of Statin Use in Women

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FDA Modifies Simvastatin Guidelines to Reduce Risk of Muscle Injury

FDA advises new patients against taking high-doses of this cholesterol-lowering drug.

Lipoprotein-a and Cardiovascular Risk Among African Americans

African Americans are more likely to have higher levels of this cholesterol, increasing their risk for heart disease.

Statins: Atorvastatin vs. Rosuvastatin

Study shows both cholesterol-lowering drugs are equally safe and effective.

Who Should Get Statins for Primary Prevention?

What every patient should know about cholesterol-lowering drugs.