I read a study this morning that is a bit concerning. It's from the US National Heart, Lung, and Blood Institute (NHLBI) and it explained that it was stopping their AIM-HIGH trial of extended release niacin (Niaspan) because the results so far were futile.
One of the causes of a stroke is a clot in the arteries of the brain. One of the potential outcomes of this study was to determine just what effect niacin had on the actual outcomes (stroke and heart attack) on their patients. The study determined after a short while that the outcomes were insignificant and not very different from a placebo.
There were a couple of issues with this study that are significant, though. First, LDL levels in the patients included were already well managed - in the range of 40-80 mg/dl, but they suffered from low HDL and high triglyceride levels. They were using various statins to maintain the low LDL level, so the niacin was introduced to primarily combat the HDL/triglyceride issues. So some of the thinking is that, once your LDL levels have been brought down to low levels, the HDL/triglyceride levels don't matter. This is something I'd like to talk to my cardiologist about.
The second, more important issue for me was the revelation that in their follow-up period after the study was cancelled (32 months), there were 28 strokes (1.6%) in the niacin group vs 12 strokes (0.7%) in the control group - statistically double the number (note that 9 of the niacin group strokes happened after niacin was discontinued). So my worry is that there may be a link between niacin and stroke (or even the discontinuation of niacin and stroke)!
I've been on a regimen of 2000mg/day of niacin (the regular, full-flush version) since 2006, the reason being to try and raise my HDL levels - which it does quite nicely. Levels before niacin were 31mg/dl, and now they are at 50mg/dl. LDL is controlled by a very small dose of Crestor (5mg/day) and remain about 50mg/dl as well.
There are some long term benefits (5-10 years) of niacin therapy, so I'm in it for the long-haul and won't change anything yet. I will keep on top of this, though, and see where this study (or lack thereof) leads...
I was in the study and just prior to the study stopping had decided to quit it because the side effects of itching had badly flared up a patch of excema on my leg. I later was confirmed that I received the 2000 daily dose. They never told me any of my levels since that might let the subject guess if they got the real dose or the placebo.
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