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Niacin Does Not Prevent Heart Attacks

A four-year trial of more than 25,000 patients with established heart disease who also took statins, showed that niacin does not prevent heart attacks, strokes, or deaths from heart disease (New England Journal of Medicine, July 17, 2014). In this study, niacin had so many serious side effects that one-third of the patients who took niacin dropped out of the study. 700,000 people take prescriptions for niacin at a cost of more than $880 million per year.

Raising HDL Cholesterol with Niacin Does Not Prevent Heart Attacks
The antioxidant vitamin niacin has been prescribed to lower cholesterol for more than 50 years. It raises HDL ("Healthy") cholesterol and lowers LDL ("Lousy") cholesterol and triglycerides. However, this study and many others show that drugs can raise the good HDL cholesterol but still not prevent heart attacks. This has led many doctors to now feel that raising the good HDL cholesterol does not, by itself, prevent heart attacks.

Lowering Lp(a) with Niacin Does Not Prevent Heart Attacks
Niacin does lower blood levels of Lp(a), a hereditary blood clotting factor that increases risk of heart attacks, but lowering Lp(a) with niacin has not been shown to prevent heart attacks (Diabetes Obesity & Metabolism, 2002;4(4):255-261).

Niacin Has Serious Side Effects
Niacin raises blood sugar to increase risk for diabetes and worsen existing diabetes. Those without diabetes who took niacin were 32 percent more likely to develop diabetes during the study. Those with diabetes were 55 percent more likely to develop severe complications from their diabetes.

Stomach bleeding and ulcers, and diarrhea occurred in 4.8 percent of those taking niacin, compared to 3.8 percent on placebo. Niacin increases stomach acidity to increase risk for stomach ulcers. Other reported side effects included itchy skin, severe muscle pain, gout, generalized infections and bleeding into the brain. Furthermore, those who took niacin had a nine percent increased risk of dying.

Bottom Line
Whatever your doctor recommends to help you prevent heart attacks, lifestyle changes are the most important:
• Lose weight if overweight
• Exercise
• Eat a diet that is loaded with fruits and vegetables and severely limits red meat, fried foods, sugared drinks and sugar-added foods
• Get blood levels of hydroxy vitamin D above 75 nmol/L with pills or intelligent exposure to sunlight
• Grow muscle
• Reduce excess body fat
• Avoid smoking and alcoholic beverages

July 27th, 2014
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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