Evidence supporting the use of: Niacin (vitamin B3)
For the body system: Heart

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Niacin (vitamin B3) has been scientifically studied for its effects on the cardiovascular system, particularly in the management of lipid profiles. Clinical trials dating back to the 1950s demonstrated that high-dose niacin can significantly lower total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides, while raising high-density lipoprotein (HDL) cholesterol. Because high LDL and low HDL are risk factors for atherosclerosis and heart disease, niacin was historically used as a lipid-lowering therapy, especially before the widespread adoption of statins. Several large studies, such as the Coronary Drug Project (1975), confirmed niacin’s benefits in reducing recurrent nonfatal myocardial infarctions, though mortality benefits were less clear.

However, more recent trials (AIM-HIGH in 2011 and HPS2-THRIVE in 2014) found that adding niacin to statin therapy did not further reduce major cardiovascular events and was associated with increased adverse effects. Despite these findings, niacin remains one of the few agents proven to raise HDL cholesterol substantially. Its use today is limited mainly to specific cases of severe dyslipidemia where other therapies are inadequate or not tolerated. Overall, the cardiovascular benefits of niacin are scientifically validated, especially regarding lipid modification, but its routine use for heart protection is now more restricted based on updated evidence.

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