Synopsis

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

Vitamin B3, also known as niacin or nicotinic acid, has been used to support and treat arteriosclerosis (hardening and narrowing of the arteries) primarily due to its beneficial effects on lipid profiles. Scientific studies, especially from the mid-20th century onwards, have shown that niacin can significantly lower total cholesterol, LDL cholesterol ("bad" cholesterol), and triglycerides, while raising HDL cholesterol ("good" cholesterol). These changes in blood lipids are associated with a reduced risk of progression of atherosclerosis, a primary form of arteriosclerosis. Several clinical trials, such as the Coronary Drug Project (1975) and the HDL-Atherosclerosis Treatment Study (HATS, 2001), demonstrated that niacin therapy could slow the progression of atherosclerotic disease and even reduce cardiovascular events in some populations.

However, more recent studies (e.g., AIM-HIGH, 2011; HPS2-THRIVE, 2014) have questioned the additive benefit of niacin when used alongside statins, leading to a decline in its widespread use for this indication. Side effects, especially flushing, and potential liver toxicity at high doses, have also limited its use. Despite this, the underlying mechanism—improvement of lipid levels—remains scientifically validated, justifying its historic and, in selected cases, ongoing use for arteriosclerosis. The evidence is moderate (rated 3/5) due to mixed results in recent large-scale trials and concerns about safety and overall benefit.

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