Is adding niacin to statin use more beneficial than statin use alone?

Carmen Patrick Mohan, MD
Internal Medicine
Nicotinic acid, or “niacin” has the following measurable and potentially beneficial actions:
1. reduces triglyceride levels by 20% to 50%
2. lowers LDL-C levels by 5% to 25%
3. prevents HDL-C destruction, which can lead to higher HDL levels (HDL-C is considered the “good cholesterol”).

Niacin is the most effective agent for increasing HDL-C, however, it is not yet clear whether the increase in HDL-C caused by niacin is actually effective in preventing heart attacks or cardiovascular disease. In clinical practice, niacin may be used in combination with statin therapy in those with suboptimal HDL-C levels (although evidence is lacking to support this practice). Niacin may also be added to a statin to achieve further reductions in LDL-C when the guideline-based LDL-C goal has not been reached through statin therapy alone. For patients unable to tolerate statin therapy, niacin may be indicated. Talk with your doctor before making any changes to your medication regimen.
Leopold D. Galland, MD
Internal Medicine
High doses of niacin (500 to 1500 milligrams per day) raise blood levels of the "good" cholesterol (high-density lipoprotein cholesterol, or HDL-C), which prevents cholesterol from being trapped in the walls of your arteries. Niacin is available as both a supplement and a prescription drug and has been shown to enhance the beneficial effects of statins on blood vessels.
Mark C. Houston, MD
Internal Medicine
Yes. The use of a statin with niacin is more effective in improving the lipid profile that either by itself. In addition the combination is better in decreasing vascular disease such as coronary heart disease and heart attack. Statins primarily reduce LDL with some reduction in triglyercides but little change in HDL except with Crestor which increases HDL slightly. Niacin increases HDL and lower triglycerides more than statins, but is less effective in lowering LDL.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.