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Low-dose, time-release nicotinic acid: effects in selected patients with low concentrations of high-density
R W Squires1, T G Allison, G T Gau
1Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905.
Insights
Low-dose nicotinic acid significantly improved high-density lipoprotein cholesterol (HDL-C) levels and other blood lipids in patients undergoing cardiac rehabilitation. This intervention offers a safe and effective option for managing dyslipidemia in this population.
Area of Science:
- Cardiology
- Preventive Cardiology
- Pharmacology
Background:
- Low high-density lipoprotein cholesterol (HDL-C) is a risk factor for cardiovascular disease.
- Patients in cardiac rehabilitation programs often have suboptimal lipid profiles despite lifestyle modifications.
- Increasing HDL-C levels is a therapeutic goal in managing dyslipidemia.
Purpose of the Study:
- To evaluate the efficacy of low-dose, time-release nicotinic acid in improving lipid profiles of patients with low HDL-C in a cardiac rehabilitation program.
- To assess the safety and tolerability of nicotinic acid in this patient cohort.
Main Methods:
- Retrospective analysis of 63 patients (treatment group) receiving nicotinic acid alongside lifestyle changes.
- Comparison with 54 control patients undergoing lifestyle changes alone.
- Monitoring of lipid profiles (HDL-C, total cholesterol, LDL-C, triglycerides) and liver enzymes.
Main Results:
- Nicotinic acid treatment led to an 18% increase in HDL-C, a 9% decrease in total cholesterol, a 13% decrease in LDL-C, and a 20% decrease in triglycerides.
- The total cholesterol to HDL-C ratio decreased by 25%.
- Nicotinic acid was well-tolerated with no intolerable side effects and minimal changes in liver enzymes and blood glucose.
Conclusions:
- Low-dose, time-release nicotinic acid effectively improves lipid profiles in patients with low HDL-C in cardiac rehabilitation.
- The intervention demonstrates a favorable safety profile for long-term use.
- Nicotinic acid represents a valuable adjunct to lifestyle modifications for cardiovascular risk reduction.
Abstract:
In a retrospective analysis, 63 participants in a cardiac rehabilitation-preventive cardiology program were identified as having low blood concentrations (mean, 34 mg/dl) of high-density lipoprotein cholesterol (HDL-C) and a mean total cholesterol level of 223 mg/dl after 3 months of hygienic measures (aerobic exercise, avoidance of tobacco, diet, and weight loss) designed to increase the HDL-C level. These patients (treatment group) were treated with low-dose, time-release nicotinic acid (mean, 1,297 mg/day) for a mean duration of 7.4 months. All subjects were able to take the drug without intolerable side effects. Fifty-four patients similar to those in the treatment group participated in the same program but were not treated with nicotinic acid (control group). Exercise, diet, body weight, and smoking remained stable throughout the period of observation. For the treatment group, HDL-C levels increased a mean of 18% (+6 mg/dl), total cholesterol concentrations decreased 9% (-20 mg/dl), the ratio of total cholesterol to HDL-C decreased 25% (from 6.8 to 5.1), low-density lipoprotein cholesterol levels decreased 13% (-20 mg/dl), and triglyceride levels decreased 20% (from 165 mg/dl to 132 mg/dl). Aspartate aminotransferase and uric acid concentrations were minimally increased after treatment, and the blood glucose level was unchanged. In the control group, HDL-C levels increased a mean of 8% (+3 mg/dl) and the other blood lipid variables were not improved after a mean of 8.3 additional months of diet and exercise.(ABSTRACT TRUNCATED AT 250 WORDS)