Niacin is an essential nutrient that has been used to lower cholesterol since the 1950s. In addition to its LDL-lowering effects, niacin is arguably the most effective agent currently available for raising HDL. I say "arguably" since in one study I've read, krill oil seems to have an even better effect (and is also much safer than 1.0 - 1.5 g of niacin, which is the therapeutic range to see the HDL benefits).
Big Pharma has been looking to develop synthetic drugs to increase HDL, without success. In fact, a number of them were in the clinical trial process when they stopped the trials and discontinued further work since the group getting the experimental drugs were experiencing a variety of dangerous side-effects.
Despite its long history as a lipid-altering nutrient, the majority of studies investigating its impact on clinical outcomes are from the pre-statin area ("statins" are the most prescribed drugs in the world and are effective at lowering LDL, but come with some dangerous side-effects themselves). Several studies have demonstrated a beneficial effect of treatment with niacin in combination with statin therapy on surrogate cardiovascular markers (e.g. carotid intima-media thickness).
Now, two large randomized trials will address whether niacin–statin combination therapy is an appropriate therapeutic alternative to statin monotherapy.
I've also heard Big Pharma combining statins with coenzyme Q10 (which is an essential nutrient that's depleted when taking statins), in hopes to minimize the negative side-effects of taking these popular drugs.
Source: The Facts Behind Niacin
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