Clinical Medicine Reviews in Vascular Health

Recent clinical trial data indicates that while normalizing serum LDL levels remains an important target in reducing adverse cardiovascular outcomes, it is not the whole story. Statins are very effective drugs for reducing LDL, but they are not sufficient to prevent the majority of cardiovascular events. The focus is now shifting towards a combined approach: reducing LDL, but also increasing HDL, low levels of which often persist despite statin treatment.

Niacin is the single most effective agent for increasing HDL, but its use has been limited because of tolerability issues affecting compliance. Niaspan-R™ is an extended-release formulation designed to reduce flushing and has been shown clinically to be as effective as immediate-release preparations. There is also a significant body of clinical evidence demonstrating the particular value of Niaspan-R™ when used in combination with existing lipid-lowering therapy. This review will consider this data and discuss the role of Niaspan-R™ in future treatment of mixed dyslipidemias.