Niacin, Statin Drug Combo Multiplies Cholesterol-Lowering
Effect
NEW ORLEANS--On Nov. 13, at the annual scientific meeting of the American
Medical Association, researchers found that niacin, coupled with a statin class
drug designed to lower cholesterol, had a magnifying effect on the percentage
cholesterol was lowered cholesterol, which ultimately decreased the risk for
heart disease.
In a three-year, double-blind, placebo-controlled trial, 160 patients were
divided into three groups using 2 g to 4 g of simvastatin (Zocor, provided by
Merck and Co. Inc.) and 10 mg to 20 mg of niacin. The cocktail was
supplemented with placebo, antioxidants (vitamins E, C, beta carotene and
selenium) or antioxidants and placebo. The fourth group received placebo, but
not the cocktail. All participants received counseling for smoking, dieting and
exercising.
The primary endpoint was the average change in percent of the nine worst
lesions in nine coronary segments. Researchers, led by University of Washingtons
Greg Brown, found that participants taking the cocktail experienced a reduction
in atherosclerosis progression and a 70-percent decrease in clinical events.
According to the media outlet Reuters, Brown said that niacin alone may
prevent almost 20 percent of non-fatal heart attacks, but that niacin combined
with a statin drug could reduce that risk by 60 to 90 percent. In addition, the
cocktail increased HDL (good cholesterol) by 30 percent, whereas statin
alone increased HDL five to seven percent.
The study concluded that the intake of antioxidants did not have an effect on
atherosclerosis for that group. Brown stated that he did not know why the
vitamin-supplemented treatment interfered with the benefits of the combination.
Antioxidant vitamins, for an unknown reason, prevent a rise in HDL, Brown
told Reuters. When you add antioxidant vitamins, the HDL rise is actually
blunted.
Brown also said that patients should not self-treat with niacin since a high
dose (which is needed to effectively work with statin drugs) may lead to frightening
flushes. Also, there is a slight risk that a high dose may negatively affect
liver enzymes and therefore should be monitored by a medical professional. For
more information, visit http://www.ama-assn.org/