Prescription of niacin can lower total cholesterol


August 01, 1999|By Joe Graedon, and Teresa Graedon | Joe Graedon, and Teresa Graedon,SPECIAL TO THE SUN

Q. I'm a 44-year-old male and an active masters swimmer. I have always eaten a low-fat diet and have a total cholesterol of 160. For all intents and purposes, I'm the picture of health.

However, I recently survived a heart attack caused by plaque and a blood clot blocking one coronary artery. Further testing showed that my HDL level is low (25) and my level of LP(a) is very high (80). I've been told that these risk factors could help explain the recent heart attack.

My cardiologist has prescribed Niaspan (timed-release niacin) to improve all my risk factors and minimize the side effects of "flushing" and liver problems. I was surprised that niacin is considered a medicine and would like to know more about it. I am planning to live another 44 years (at least), and would like to stop or reverse atherosclerosis now.

A. Cardiologists have known for a long time that cholesterol is not the only, or even the most important, risk factor for heart disease. Many people with low cholesterol scores like yours develop plaque in their coronary arteries anyway.

Your low HDL level is a problem. So is your elevated Lp(a). Triglycerides, homocysteine and the size of lipid particles in the blood can all affect heart health.

Niacin is quite effective for lowering total cholesterol and triglycerides and raising good HDL levels. Large doses can increase liver enzymes and uric acid and interfere with blood sugar control, however, so close monitoring is required.

Write to the Graedons in care of The Sun, 501 N. Calvert St., Baltimore, Md. 21278, or e-mail to

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