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This is a landmark study that suggests that using niacin in combination with a statin drug can reduce hardening of the arteries, which can lead to heart attack or stroke. Participants in this study already had heart disease or were at risk of heart disease due to diabetes or other health conditions and were also taking a statin. In addition, one half of the participants were assigned to either extended-release niacin (commonly known as Vitamin B3); the other half took ezetimbe (which is commonly known as Zetia).
As expected, this well designed and executed study found that niacin raised HDL (good cholesterol) about 20% while ezetimibe lowered LDL (bad cholesterol) about 20%. However, only niacin reduced plaque buildup in the neck (carotid) arteries. Remarkably, the improvement occurred within eight months of starting niacin treatment. Plaque build up in the carotid artery is a good marker of cardiovascular disease.
At the University of Maryland, we are part of two major studies that will determine whether these therapies also reduce the risk of heart attacks and heart related death. The first trial is an NIH sponsored study that examines whether combining niacin and statin reduces heart attacks to a greater extent than statin alone. The second study examines whether Zetia plus a statin is more protective to the heart than statin alone. These studies will not be completed until 2011-2012.
Based on the current study, niacin and a statin may turn out to be the winning combination needed to effectively treat cholesterol and combat heart disease.