No Benefit from Niacin in Seniors with Coronary Artery Disease

A study from Johns Hopkins has found that “routine prescription of extended-release niacin, a B vitamin (1,500 milligrams daily), in combination with traditional cholesterol-lowering therapy offers no extra benefit in correcting arterial narrowing and diminishing plaque buildup in seniors who already have coronary artery disease.”

According to a press release from Johns Hopkins, investigators used carotid MRI scans (at baseline and again every six months) to measure the reduction in plaque buildup in 145 men and women (all age 65 years or older) with existing atherosclerosis and one or more pre-existing cardiovascular health issues.

Follow up revealed that “after 18 months of drug therapy, reductions in arterial wall thickness were measurably no different between the half who took dual niacin-statin therapy and the rest who remained on statin therapy alone.” Patients treated with statins and niacin had an average plaque reduction of 5.4 cubic millimeter per month; patients treated with statins alone had an average reduction of 4 cubic millimeters per month.

The study results did indicate one bit of positive news: LDL levels fell 5% more and HDL levels increased 14% more in patients treated with statins and niacin compared to patients who received only statins.

Joao Lima, MD, senior study investigator and a cardiologist at Johns Hopkins, said that these findings “tell us that improved cholesterol levels from taking combination vitamin B niacin and statin therapy do not necessarily translate into observable benefits in reversing and stalling carotid artery disease.” However, this does not mean that “niacin therapy may not have other cardiovascular benefits, but any such benefits are independent of reducing the amount of plaque buildup and patients should be aware of that,” said Lima.

Based on these findings, the researchers’ recommendation to physicians is that “current national treatment guidelines, which recommend mainly statin therapy tailored to the severity of atherosclerosis for preventing arteries from reclogging and narrowing, appear to be sufficient and accurate for physicians and patients to follow,” said Lima.

The team presented its findings at the recently concluded the American Heart Association’s (AHA) annual Scientific Sessions in Orlando.