Evidence supporting the use of: Niacin (vitamin B3)
For the health condition: Arteriosclerosis

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Niacin (vitamin B3) has a scientifically validated role in the management of arteriosclerosis, particularly due to its effects on blood lipid profiles. Niacin is one of the oldest lipid-modifying agents and has been used since the 1950s to treat hyperlipidemia. Clinical studies have demonstrated that niacin can significantly increase high-density lipoprotein (HDL) cholesterol and lower low-density lipoprotein (LDL) cholesterol, triglycerides, and lipoprotein(a)—all of which are relevant risk factors in the development and progression of arteriosclerosis (the thickening and hardening of arterial walls due to plaque buildup). Several major clinical trials, such as the Coronary Drug Project and the HATS (HDL-Atherosclerosis Treatment Study), have shown that niacin therapy can reduce cardiovascular events and slow the progression of atherosclerotic disease. However, more recent studies, including AIM-HIGH and HPS2-THRIVE, have questioned the additive benefit of niacin when used on top of statins, especially in reducing cardiovascular events, despite improvements in lipid parameters.

Niacin is not without side effects, notably flushing, gastrointestinal upset, and, rarely, liver toxicity. Its use has declined somewhat due to these side effects and the widespread adoption of statins, which are often better tolerated and have robust evidence for reducing cardiovascular risk. Nonetheless, niacin remains a scientifically recognized, though now less commonly used, treatment for patients with specific lipid abnormalities contributing to arteriosclerosis.

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