The National Institutes of Health stopped a clinical trial studying a blood lipid treatment 18 months early. The study found that adding high dose, extended release niacin to statin treatment for patients with heart disease did not reduce cardiovascular events, such as heart attacks and strokes.
This study was referred to as AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides: Impact on Global Health) and the 3414 participants were selected because they were at risk for cardiovascular events despite having a well controlled LDL cholesterol level. They were at increased risk due to a history of heart disease combined with low HDL cholesterol and high triglycerides. Low HDL levels and high triglycerides are both linked to increased risk of cardiovascular events.
Studies have shown that lowering LDL cholesterol reduces risk for cardiovascular events, while studies have not shown a conclusive link between raising HDL cholesterol and reduced cardiovascular events.
Study participants were divided into two groups.
Group 1 - Received high dose, extended release niacin (Niaspan) in doses that gradually increased to 2000 mg per day (Niacin - vitamin B3 - raising HDL cholesterol and lowers triglycerides.)
Group 2 - Received a placebo
All participants received simvastatin, with a few (515) receiving a second LDL lower drug, ezetimibe. LDL cholesterol levels were maintained between 40-80 mg/dL. (Makes me think of this post - Dangers of Too Low Cholesterol: Are you at risk? Although, this article is talking about total cholesterol and not LDL specifically.)
During the 32-months the study was in progress, participants receiving high dose, extended-release niacin and statin treatment increased their HDL cholesterol and reduced triglycerides when compared to those receiving statins alone.
You would think this means those individuals with higher HDL cholesterol and lower triglycerides were at reduced risk for cardiovascular events.
Unfortunately, this was not the case. The combination treatment did not lower fat and non-fatal heart attacks, strokes, hospitalizations for acute coronary syndrome, or revascularization procedures to improve arterial blood flow.
What does this mean?
I think this goes to show that there is more at play in your risk for heart disease than cholesterol alone. The main culprit is inflammation. If you are living with an ‘inflamed interior' then it doesn't matter how low you get your LDL cholesterol or how high your HDL, your system is still ripe for oxidation which starts the process of arterial plaque, heart disease, and leads to cardiovascular events.
Published On: July 16, 2011