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Sunday, February 20, 2011

Nicotinic Acid or Niacin Prevents Atherosclerosis

Posted by Prahallad Panda on 6:08 PM Comments

The illustration shows a normal artery with no...Image via Wikipedia
Most common cause of heart attacks and brain strokes is due to atherosclerosis. An early treatment of atherosclerosis is therefore crucial to preventing cardiovascular diseases. Researchers have demonstrated that the LDL(low density lipoproteins) lowering drug nicotinic acid also called niacin or vitamin B3, halts the inflammation of blood vessels. Previously it had been assumed that nicotinic acid mostly alleviates atherosclerosis by reducing the concentration of bad cholesterol and by boosting HDL or good cholesterol in the blood.
Atherosclerosis is a chronically progressive alteration of the arterial wall that can develop over a period of time, in which cholesterol accumulates in the inflamed inner cell layer of the arteries.
New research has shown that it is mainly the chronic inflammation of the vascular wall that promotes atherosclerosis and may lead to acute illnesses such as a cardiac infarction. The classic treatment concept aims to lower harmful lipids such as LDL (low-density lipoprotein) cholesterol or triglycerides, and to increase beneficial lipids, such as HDL (high-density lipoprotein) cholesterol.
In genetically modified mice, it has been demonstrate that nicotinic acid strongly inhibits the progression of atherosclerosis, just as in humans. In mice that lacked the nicotinic acid receptor GPR109A, the agent had no effect on atherosclerosis. In contrast to human cholesterol levels, the cholesterol levels of mice remain constant despite the administration of nicotinic acid. This suggests that nicotinic acid does have an anti-atherosclerotic effect via its receptor, but that this is not due to a change in the lipid concentration.
Further studies showed that the nicotinic acid receptor is present in different immune cells. For example, the receptor was found in macrophages in atherosclerotic blood vessels. When the scientists intentionally blocked the receptor in the cells of the immune system, the effect of the nicotinic acid disappeared. This suggests that the receptor expressed by immune cells transmits the anti-atherosclerotic effect.
These findings suggest that the beneficial impact of nicotinic acid, one of the oldest agents used against atherosclerosis, inhibits inflammation in vascular walls and thereby atherosclerosis.
The unfortunate part of this vitamin is large dose requirement to be effective, mostly 1000 to 2000 mgs/day; that may show different side effects. To minimise the side effects sustained release form is more suitable. Therefore, its dose is gradually increased seeing response and adverse effects in patients.
Nicotinic is available singly and in combination with ezitimibe a triglyceride lowering drug. It is available from vegetables, animal food, diary products and mushroom etc. Its deficiency causes pellagra, mostly seen in maize consuming population because maize is deficient in niacin.
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