Cardiac Health in the News: The Dangers of Niacin for High Cholesterol Patients

With heart disease being the leading cause of death in the United States, researchers are constantly studying its causes and risk factors. As a consequence, it’s rare that a month goes by without at least one cardiac health-related news item, and this month is no exception.

In this article, we'll cover the first of three such news items, and follow with the other two in a subsequent posts.

Niacin is Dangerous for People With High Cholesterol

Last week, the New York Times reported that niacin, which has been a popular treatment for people with cardiovascular disease, is no longer recommended. Apparently, a recent study published in the New England Journal of Medicine now gives doctors serious pause, and here’s why:

The new studies failed to show that niacin reduced the risk of heart disease and stroke.

The studies found that patients taking niacin had about the same rates of heart disease, stroke and death as those who took a placebo with no active ingredients.

Scientists have known for decades that niacin affects lipid levels in the blood, but they never designed a study to determine if it led to fewer heart attacks, strokes, and deaths. They also never studied its effects on patients who were also taking statin drugs at the same time.

These recently published studies were different. They took into account the statin drugs, and tested different levels of niacin (an extended-release formula, and a combination of extended-release niacin and laropiprant, an agent designed to make the niacin more tolerable), and in both cases, found no benefit to patients. In fact, they even stopped the American study early because the chances of finding any benefit became so remote that there seemed to be no point in continuing with the research.

Niacin causes multiple side effects, many of which are serious.

Research also showed that niacin has the potential to cause great harm in cardiac patients. Side effects include uncomfortable flushing and itching, as well as much more serious concerns like diarrhea and ulcers; musculoskeletal problems such as muscle damage; gout; rashes, skin ulcerations and other serious skin-related problems; and gastrointestinal bleeding or other bleeding.

In addition, patients on niacin were 32 percent more likely to receive a diagnosis of diabetes than those not on the drug, and in those with diabetes, niacin increased the risk of serious problems with disease management by 55 percent.

The bottom line:

No study is perfect, and these studies did focus on high-risk cardiac patients, but if you are taking niacin, talk with your doctor about whether you should continue. If you are not taking niacin, then the news is, there is little reason to start.

Slidell Memorial is the most experienced in cardiac services on the Northshore, consistently being first to offer new, innovative services in cardiac care. We invite you to learn more about our cardiac services, and our new state-of-the-art Heart Center, and to contact us to set up a consultation with one of our caring clinicians today.