Niacin in cardiovascular prevention: mechanisms, efficacy, and safety

@article{Guyton2007NiacinIC,
  title={Niacin in cardiovascular prevention: mechanisms, efficacy, and safety},
  author={John R. Guyton},
  journal={Current Opinion in Lipidology},
  year={2007},
  volume={18},
  pages={415–420}
}
  • J. Guyton
  • Published 1 August 2007
  • Biology, Medicine
  • Current Opinion in Lipidology
Purpose of review This review describes niacin's mechanism of action, efficacy in cardiovascular prevention, and safety. Recent findings A G-protein-coupled receptor [GPR109A/HM74A, mouse PUMA-G (protein upregulated in macrophages by interferon-γ)] was found to mediate the antilipolytic effect of niacin via inhibition of adenylyl cyclase in adipocytes. The same receptor in skin Langerhans cells mediates the common flushing side effect. The endogenous ligand for the receptor may be… 
Niacin: another look at an underutilized lipid-lowering medication
TLDR
The utility of niacin is reviewed including its mechanism of action, clinical trial data regarding cardiovascular outcomes, adverse effect profile and strategies to address these effects and improve compliance are reviewed.
Abstract and Introduction
TLDR
It is unlikely that any chronic lowering of BP by niacin is due to dilation of dermal vessels through activation of the DP1 receptor by PGD 2 , and further research is warranted to evaluate the extent and mechanisms of niacIn's effects on BP.
Effect of Extended-Release Niacin or Ezetimibe on Carotid Intimal Thickness: The ARBITER-HALTS Study
  • J. Farmer
  • Medicine, Biology
    Current atherosclerosis reports
  • 2010
TLDR
The recent release of ezetimibe was welcomed as another pharmacologic approach to modify the lipid profile either in monotherapy or in combination with statins, but doubts about the clinical utility were raised when it failed to reduce carotid intimal thickness when added to full-dose simvastatin therapy.
Safety and efficacy of laropiprant and extended-release niacin combination in the management of mixed dyslipidemias and primary hypercholesterolemia
TLDR
The uptake in clinical practice of the niacin–laropiprant combination will depend on the relative improvements experienced by the patient in the side-effect profile compared to other treatment options, as well as on the the keenly-awaited outcome studies currently underway.
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TLDR
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Does nicotinic acid (niacin) lower blood pressure?
TLDR
It is unlikely that any chronic lowering of BP by niacin is due to dilation of dermal vessels through activation of the DP1 receptor by PGD2, but post hoc analyses of some of the more recent nacin clinical trials also support a more chronic, dose‐dependent, BP‐lowering effect of niacIn.
Expression of the Niacin Receptor GPR109A in Retina: More than Meets the Eye?
TLDR
Preclinical and clinical studies documenting the expression of GPR109A are described, the pleiotropic effects elicited in response to its activation and the underlying mechanisms to explain these actions are described.
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