Yesterday’s issue of the New England Journal of Medicine reports that the very inexpensive nutritional supplement niacin worked better to clear arteries than the not so cheap and side effect rich drugs Zetia– a drug used in addition to a statin, and Vyotrin– a single pill which combines a statin with Zetia.
Much of the information I’m posting here comes from The Washington Post.
A recent trial gave 200 people one of the drugs or Niaspan, a form of the B vitamin Niacin. They were followed for 14 months. The results showed a decrease in artery clogging plaque in the niacin group but none in the pharmaceutical group. It’s plaque that causes problems and deaths not the cholesterol itself.
Vytorin and Zetia are among the most popular prescription drugs and were introduced with lots of fanfare and expensive advertising. Don’t worry though, Merck made their money back on those expenses. Last year, physicians in the United States wrote a total of more than 29 million prescriptions for them, and worldwide sales totaled $4.56 billion, according to Merck.
Critics of the study complained that it involved just 200 patients, was ended early, and examined what is known as a surrogate marker — the amount of plaque on artery walls — rather than evaluating the rate of heart attacks and stroke.
The study’s author, Allen J. Taylor of Walter Reed Army Medical Center and Washington Hospital Center, said the trial ended early because the results were quickly apparent. “It couldn’t be more clear,” Taylor said. “It would have been unreasonable to continue the experiment because the trial had met its objective — niacin is superior to ezetimibe.”
Because plaque can clog arteries and restrict blood flow to the heart and brain, cardiologists view plaque as a good indication for the risk of heart attack and stroke.
The patients who took Niaspan had less plaque in their arteries and also had higher levels of high-density lipoprotein or HDL. Known as “good” cholesterol, HDL is believed to remove cholesterol from the arteries and carry it back to the liver, where it is passes from the body.
The patients who took Zetia had more plaque in their arteries but lower levels of LDL. They also had more heart attacks, strokes and other cardiovascular problems than the patients taking niacin.
If you are on Zetia or Vyotrin please find out more about using niacin as a safe alternative. And if you are worried about LDL cholesterol being some form of evil to be avoided at all costs, please stop back here tomorrow and the days following. I’m going to do my best to explain simply why it’s not evil, why HDL and triglyceride levels are much more important to pay attention to, and why low levels of cholesterol is unsafe at any age but especially midlife and beyond.
