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Study Reveals Links Between Cardiovascular Disease and High Levels of Niacin

Feb. 22, 2024

Niacin, a common B vitamin, previously was used as a treatment for high cholesterol and is found in staple ingredients like flour

Matt MacKenzie

A new study has identified a pathway that contributes to cardiovascular disease associated with high levels of niacin.

Niacin, which is a “common B vitamin previously recommended to lower cholesterol,” is very common in Western diets. However, this study’s results showed “higher circulating levels of 4PY,” a breakdown product from excess niacin, “were strongly associated with development of heart attack, stroke, and other adverse cardiac events.” 4PY can also trigger “vascular inflammation which damages blood vessels and can lead to atherosclerosis over time.”

Dr. Stanley Hazen, who led the research team, emphasizes that this new study opens up “potential for diagnostic testing.” One in four patients in the researchers’ cohorts “appear to be getting too much” niacin “and had high levels of 4PY, which appears to contribute to cardiovascular disease development.”

Many nations, including the United States, have “mandated niacin fortification in staple foods such as flour, cereals, and oats to prevent disease related to nutritional deficiency,” Dr. Hazan said. However, given these findings, he said that “a discussion over whether a continued mandate of flour and cereal fortification with niacin in the U.S. could be warranted.”

Dr. Hazan also points out that “use of over-the-counter supplements made with different forms of niacin have also become popular because of presumed anti-aging purposes.” He stresses that patients “should consult with doctors” before taking over-the-counter supplements.

In addition, niacin was one of the first treatments “prescribed to lower LDL or ‘bad’ cholesterol.” However, it is no longer a go-to treatment for lowering cholesterol, as it showed to be “less effective than other cholesterol-lowering drugs and was associated with other negative effects and higher mortality rates in previous research.” Dr. Hazan believes that his research team’s findings may help explain that “paradox.”

Cleveland Clinic’s website has the news.