Does niacin prevent heart attacks?

Niacin, also known as vitamin B3, is a nutrient that’s made and used by your body to turn food into energy. It helps keep your nervous system, digestive system, and skin healthy. But does it prevent heart attacks? Let’s explore this.

Niacin is often part of a daily multivitamin, but most people get enough niacin from the food they eat. Foods rich in niacin include yeast, milk, meat, tortillas, and cereal grains. People use prescription niacin to help control their cholesterol. The recommended daily amount of niacin for adult males is 16 milligrams (mg) a day and for adult women who aren’t pregnant, 14 mg a day.

Prescription niacin is used to increase high-density lipoprotein (HDL) cholesterol — the “good” cholesterol that helps remove low-density lipoprotein (LDL), the “bad” cholesterol, from your bloodstream. Despite niacin’s ability to raise HDL, research suggests that niacin therapy isn’t linked to lower rates of death, heart attack, or stroke.

In fact, a major study of high-dose niacin was halted more than a year ahead of schedule because of the lack of benefit. It was the latest setback in the quest to harness good cholesterol to fight the bad kind. LDL cholesterol is the main source of artery clogs. Popular statin drugs are mainstays in lowering LDL.

Yet many statin users still suffer heart attacks, because LDL isn’t the whole story. Low levels of HDL, the good kind that helps prevent artery clogs, as well as too many triglycerides, a different fat, also increase heart risk.

The study tested an extended-release form of niacin that is a far higher dose than is found in dietary supplements. More than 3,400 statin users in the U.S. and Canada — people still at risk of a heart attack because of low HDL levels — were given either this form of niacin or a dummy pill to add to their daily medicine.

As expected, the niacin users saw their HDL levels rise, and their levels of risky triglycerides drop, more than people who took a statin alone. But the combination treatment didn’t reduce heart attacks, strokes, or the need for artery-clearing procedures such as angioplasty.

Also, there was a small increase in strokes in the high-dose niacin users. The researchers said it was not clear if that small difference was merely a coincidence, as previous studies have shown no stroke risk from niacin. In fact, some of the strokes occurred after the niacin users quit taking that drug. Researchers said patients shouldn’t stop taking their niacin without talking to a doctor first.

In conclusion, while there seems to be some potential for niacin to help increase HDL cholesterol levels, there’s a lack of research showing that it can prevent heart attacks. As always, if you’re considering taking niacin or any other supplement for these purposes, it’s important to talk to your healthcare provider.

They can provide guidance based on your individual health needs and circumstances. Remember, maintaining a balanced diet, regular exercise, and a healthy lifestyle are key to supporting overall health, including cardiovascular health.