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# You can lower cholesterol, but can't cut cardiovascular risk
- URL: https://www.foodconsumer.org/you-can-lower-cholesterol-but-can-t-cut-cardiovascular-risk/
- Published: 2011-06-01T23:24:00.000Z
- Updated: 2026-09-22T15:43:50.000Z
- Description: A trial halted 18 months early found that adding niacin to statins in 3,412 high-risk patients raised HDL and lowered LDL but did not cut heart attacks, strokes or hospitalizations for acute coronary problems or revascularization.
- Author: Food Consumer
- Tags: Nutrition, Heart Disease, Stroke, Cholesterol, Niacin, Statins, #vivvo-import

By David Liu, Ph.D. and Elizabeth Hutchinson

Wednesday June 1, 2011 (foodconsumer.org) -- Many researchers have already claimed that low, high density lipoprotein or HDL is a risk factor for cardiovascular disease and that high doses of niacin or vitamin B3 can be used to raise this so-called good cholesterol, and hopefully cut cardiovascular risk.

A new study, which was terminated 18 months prior to the scheduled completion date, resulted in sufficient evidence to suggest that niacin therapy coupled with the use of statins can raise good cholesterol, but the high levels of good cholesterol and low levels of bad cholesterol resulting from this treatment did not reduce the risk of cardiovascular events, including heart attacks and stroke, among those who were considered at high risk for cardiovascular disease, according to the National Heart, Lung and Blood Institute.

In the study, subjects had their levels of low density lipoprotein (LDL) or bad cholesterol well controlled, but still remained at high risk for cardiovascular disease because they had a history of cardiovascular disease, low good cholesterol, and high triglycerides.

Previous studies have linked low good cholesterol and high levels of triglycerides with an increased risk of cardiovascular events. Reducing bad cholesterol is known to cut the risk of cardiovascular disease. The current study suggests increasing good cholesterol and lowering triglycerides could not reduce the risk of fatal heart attacks, non-fatal heart attacks, strokes, or hospitalizations for acute coronary problems or revascularization procedures, which are intended to better blood flow in the blood vessels or arteries.

In the study, 3,412 people in the U.S. and Canada with an average age of 64 years who were considered at high risk of cardiovascular disease or events, were given a prescribed statin called simvastatin, or Zocor. Half of the people were also given two grams of niacin (Niaspan, which releases niacin gradually), while the other half was given a placebo. 515 people were given a second statin called ezetimibe, or Zetia. The drugs were taken to lower bad cholesterol to a level between 40 and 80 mg/dL.

Prior to the study, 92 percent of the participants had coronary artery disease, 71 percent had high blood pressure, 34 percent suffered diabetes, and 81 percent experienced metabolic syndrome. More than 50 percent had suffered at least one heart attack prior to the study.

All participants were followed for 32 months. Among those who were given niacin, 28 cases of stroke (1.6% of the group) were identified. This is compared to 12 strokes, or 0.7% in the placebo group. This means niacin users were more than twice as likely as nonusers to suffer stroke. Excessive strokes were also found post-treatment.

Study participants will be followed for another 14 to 20 months.

Dietary niacin and supplemental niacin are unlikely to cause any toxic events. However, the dosage used in the study is so high that experts say it should be considered a drug.

Some researchers suggest that cholesterol does not play a major role in risk of cardiovascular disease or events in the first place. Calcium may play a more important role. But, how niacin, when used as a pharmacologic agent as in the current study, increases the risk of stroke remains unknown.

Niacin in high doses is ineffective in reducing the risk of cardiovascular events in those who have already been diagnosed with cardiovascular disease as a 2009 study revealed.

The Food and Nutrition Board recommends that the dietary allowance for niacin for males aged 19 or older be 16 mg per day. It is 14 mg per day for female adults, 18 mg per day for pregnant women, and 17 mg per day for breastfeeding women.

Photo credit: wikipedia