Niacin–Statin Study Didn't Give Desired Results: Stopped Early
The National Institutes of Health stopped a clinical trial studying a blood lipid treatment 18 months early. The study found that adding high dose, extended release niacin to statin treatment for patients with heart disease did not reduce cardiovascular events, such as heart attacks and strokes.
Study Participants
This study was referred to as AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides: Impact on Global Health) and the 3414 participants were selected because they were at risk for cardiovascular events despite having a well controlled LDL cholesterol level. They were at increased risk due to a history of heart disease combined with low HDL cholesterol and high triglycerides. Low HDL levels and high triglycerides are both linked to increased risk of cardiovascular events.
Study participants were divided into two groups.
Heart Failure and Statin Drugs
The type of heart failure you have may determine the effectiveness of a statin medication.
Types of Heart Failure
Systolic heart failure is when the heart does not contract forcefully enough to pump blood out of the aorta and into circulation.
Diastolic heart failure is when the heart does not relax properly to allow an adequate volume of blood to fill the left ventricle.
Statin Drug Treatment and Potential Complications
Lower Cholesterol – Is grapefruit juice safe with medications, such as Lipitor?
Here’s another question I asked Dr. Cynthia Shelby-Lane and her answer.
Lisa Nelson RD: Is it safe for individuals taking medication for heart disease, such as Lipitor, to eat grapefruit or drink grapefruit juice?
Dr. Shelby-Lane: I am including information that may help answer your question about grapefruit and a variety of nutritionals that affect statin drugs for the lowering of cholesterol.
Zocor (Simvastatin), for example, is a Statin drug, used to lower high cholesterol levels, and also known as HMG-CoA reductase inhibitor. Zocor may affect the absorption or utilization of vitamins E and coenzyme Q10. Tests showed the average concentration of coenzyme Q10 in blood plasma decreased by approximately 50% after statins were used for 30 days. Supplementation is considered beneficial.
Grapefruit and grapefruit juice may increase the effects of HMG-CoA reductase inhibitors and should not be consumed at the same time. It is suggested that these medications be taken with water. Grapefruit contains substances that may inhibit the body’s ability to break down statin drugs increasing the toxicity of the drug. Muscle pain, tenderness, or muscle weakness may be a result. If you begin to notice these symptoms, contact your doctor.
Niacin is the form of vitamin B3 used to lower cholesterol. Large amounts of niacin taken with a statin drug may cause serious muscle disorders (myopathy). Reasonable levels of niacin combined with statin drugs have been shown to enhance the cholesterol lowering effect. For proper dosage, consult your physician before taking niacin.
Pomegranate juice has been shown to inhibit the same enzyme inhibited by grapefruit juice. This may cause reactions similar to grapefruit juice when it is used with statin drug treatments.
A study of 37 people with high cholesterol treated with diet and statin drugs found vitamin A increased in the blood over two years of therapy. People taking statin drugs and vitamin A supplements should have blood levels of vitamin A monitored.
Magnesium and aluminum containing antacids were reported to interfere with statin drug absorption. To avoid this interaction, take statin drugs two hours before or after any aluminum/magnesium containing antacids. Some magnesium supplements such as magnesium hydroxide are also antacids.
It should be noted that doctors often recommend supplementing with 100 mg of coenzyme Q10 per day for maintaining healthy levels. However, those on statin drugs may have a greater need for a higher dose. It further should be noted that the symptoms associated with the combination of grapefruit juice and statin drugs (muscle weakness and discomfort) are commonly reported as symptoms associated with CoQ10 depletions. Supplementation with coenzyme Q10 is strongly recommended.
The herbs Artichoke plant, Garlic and Plantain may decrease blood cholesterol levels, and therefore enhance the effects of Zocor. Consult with your pharmacist or physician before taking them.
All the best,
Lisa Nelson RD
Be Heart Healthy and Lose Weight
