title: Niacin-a critical component to the management of atherosclerosis: contemporary management of dyslipidemia to prevent, reduce, or reverse atherosclerotic cardiovascular disease.
abstract: Niacin (nicotinic acid) is the most effective agent for raising high-density lipoprotein cholesterol levels and can improve the entire lipid panel in patients with dyslipidemia. Niacin-containing regimens are among the few treatments studied for dyslipidemia that have both elicited significant reductions in atherosclerotic progression (by angiography or imaging) and also significantly reduced (by approximately 90% vs control) the incidence of cardiovascular events in a single clinical trial. However, cutaneous flushing-an uncomfortable but typically transient adverse effect of niacin-often results in patient nonadherence with this potentially life-saving therapy. Effective counseling regarding the highly favorable benefit-risk ratio for niacin and management strategies such as careful dose escalation, follow-up monitoring, regimen adjustments, and the use of treatment adjuncts (eg, aspirin) can improve patient adherence with niacin therapy. Clinicians are uniquely positioned to provide such counseling to appropriate patients for niacin treatment and hence encourage wider use of this important and necessary cardioprotective medication.
authors.affiliation: Cardiology Division, LifeLink Healthcare Institute, Tampa, FL, USA. cm_mason@msn.com
authors.forename: Carol M
authors.initials: CM
authors.lastname: Mason
authors.forename: Amy L
authors.initials: AL
authors.lastname: Doneen
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000517:prevention & control*; D003376:Counseling; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D050171:Dyslipidemias / Q000188:drug therapy*; D005483:Flushing / Q000139:chemically induced / Q000628:therapy; D006801:Humans; D000960:Hypolipidemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D055118:Medication Adherence; D009525:Niacin / Q000494:pharmacology / Q000627:therapeutic use*; D011537:Pruritus / Q000139:chemically induced / Q000628:therapy
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000960:Hypolipidemic Agents; D009525:Niacin; D001241:Aspirin