The Zetia Versus Niacin Debacle

by Lisa Nelson, RD, LN Health Professional

I'm all for promoting heart health and lowering cholesterol through the use of wise food selections. I do not spend a lot of time staying up-to-date on the latest research for cholesterol lowering medications. It often feels like pharmaceutical company's often get wrapped up in dollar signs and forget the bottom-line reason for manufacturing the medication - improving your health. Well, a study comparing Niacin and Zetia caught my eye and I wanted to share the results.

This study was published in the New England Journal of Medicine this past November 2009. Researchers analyzed the effect of extended-release niacin and ezetimibe (Zetia) on LDL cholesterol and HDL cholesterol levels.

Patients with coronary heart disease and receiving long-term statin therapy were enrolled in the study. Study participants were randomly assigned to receive 10 mg ezetimibe per day or 2000 mg extended-release niacin (vitamin B3) per day in addition to their statin medication. Arterial plaque was evaluated by measuring the carotid intima-media thickness.

After 14 months, HDL cholesterol increased 18.4% in individuals receiving niacin. Individuals receiving niacin also experienced reductions in triglycerides and LDL cholesterol. LDL cholesterol decreased 19.2% for those receiving ezetimibe. Those receiving ezetimibe had reduced triglyceride levels, but their HDL levels dropped also (not good). Remember, HDL cholesterol is typically considered good and the higher your levels the better (although there are exceptions). Individuals in the niacin group had a greater improvement in mean carotid intima-media thickness (reduced arterial plaque) versus the ezetimibe group.

Also, individuals in the extended-release niacin group had fewer adverse cardiovascular outcomes, such as heart attacks and heart disease related deaths.

The study was actually terminated early due to the positive results seen with niacin and negative impact of ezetimibe. Researchers concluded that the use of extended-release niacin results in a significant decrease of arterial plaque when combined with a statin and that niacin is superior to ezetimibe.

Pharmaceutical companies are not necessarily thrilled by these results because niacin is not a costly medication and does not lead to high profits. Niacin isn't even really a medication. It's a vitamin. This study re-enforces just how much nutrition and nutritional supplements have a drastic impact on your heart health.

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Lisa Nelson, RD, LN
Meet Our Writer
Lisa Nelson, RD, LN

Lisa Nelson RD, a registered dietitian since 1999, provides step-by-step guidance to lower cholesterol and lower blood pressure, so you can live life and enjoy your family for years to come. Lisa's passion for health comes from her own family history of heart disease, so she doesn't dispense trendy treatments; Lisa practices what she teaches in her own daily life. Because her own health is the foundation of her expertise, you can trust that Lisa will make it truly possible for you to see dramatic changes in your health, without unrealistic fads or impossibly difficult techniques.