Use of Niacin in the Prevention and management of Hyperlipidemia
With the use of niacin dating back long before the use of many of today’s common meds for high cholesterol levels, it is disappointing that it is not more widely used. This review article address the efficacy and safety of this time-tested treatment for hyperlipidemia. One side effect of niacin therapy, however, is the flushing that comes from the doses needed to achieve a clinical response (usually 1500-3000 mg). I have read that using one baby aspirin 1/2 hour before taking the niacin can de-activate the histamine release and prevent the flushing.
Prog Cardiovasc Nurs 6(1):14-20, 2001 Niacin is an inexpensive drug useful in treating various forms of hyperlipidemia. Cardiac doses of niacin are effective in lowering serum triglyceride, low density lipoprotein, and lipoprotein-a levels and in elevating high density lipoprotein levels. Adverse reactions to niacin are varied and dose-dependent and range from annoying cutaneous flushing to hepatic toxicity. Patients advised to use the drug should be carefully screened and monitored. This paper reviews the pathologic and pharmacologic basis for niacin as an antilipemic agent. The biochemical and physiologic effects of the drug and its mechanisms of action are discussed. Emphasis is placed on the importance of aggressive management of serum lipids and the therapeutic uses of niacin. The use of niacin in primary and secondary prevention of heart disease is stressed. A patient education guide is included. T he current decline in coronary heart disease (CHD) in the U.S. may be attributed more to the prolongation of life among those with existing disease than to a decrease in the absolute number of deaths. Further decline in the CHD death rate will most likely depend upon successful secondary prevention of heart disease. Single or combined drug therapies together with maintenance of a healthy lifestyle are central to successful prevention of recurrent thrombotic events in coronary arteries. Ultimate success in decreasing the incidence of CHD will depend upon primary prevention of new onset of the disease.The combination of lifestyle changes and drug therapy has been shown to be effective in both primary and secondary prevention of CHD. One of the oldest drugs in the CHD armamentarium is nicotinic acid, commonly known as niacin. First used as a hyperlipidemic agent in 1955, niacin is a readily available, inexpensive mainstay of adjunctive therapy for prevention and treatment of CHD. This paper briefly reviews the pathology of hyperlipidemia and discusses the use of plain and immediate-release niacin as well as a new, extended-release form of niacin in secondary and primary prevention of CHD. Emphasis is placed on the clinical impact of the adverse effects of niacin as well as the role of the primary care provider in recommending its use.