Niacin

The results the HPS2-THRIVE trial were presented at the ACC the other day. In this large trial, niacin was shown NOT to prevent major adverse Cardiovascular events any more than placebo. This is despite causing average reductions in LDL of 10 mg/dL and triglycerides of 33 mg/dL, in addition to a 6 mg/dL increase in HDL.

When interpreting a trial like this, it is important to understand the patient population studied. These were patients at high risk that already had LDL < 70mg/dL. This is important to understand. In patients like this, it is clear that niacin does not work. But what about patients who are on statin with an LDL > 70mg/dL? Many of these patients are on niacin for its LDL lowering properties and not for it HDL raising properties, as was studied in this trial. The jury is still out?

If you currently take niacin therapy, I suggest you discuss whether or not you should continue using it prior to discontinuing it on your own.