The latest study results are not sufficient to merit a change in current treatment guidelines, he says, for people with coronary artery disease, namely, recommending statin therapy alone as a first step in treatment. And if statin therapy does not help patients reach their target cholesterol levels, "only then should add-on therapy, such as niacin be considered." However, the HALTS study along with a recently published study from Oxford University supports the add-on use of niacin "as a preferred second, cholesterol-lowering agent."

Co-editorial author and cardiologist Erin Michos, M.D., M.H.S., also at Hopkins, says that several large, ongoing international studies on the long-term vascular benefits of niacin and ezetimibe - in particular studies called AIM-HIGH and IMPROVE-IT- should provide more definitive data about whether these drugs lower rates of heart attack and stroke when used in combination with a statin, or if statin therapy works better alone. Hopkins is participating in that research, as well.

Indeed, Michos says, preliminary results from another Johns Hopkins study, also to be presented at the AHA's Scientific Sessions on Wednesday, will show that niacin does not help reduce the volume build up of plaque inside the arterial wall in people taking statin therapy who already had higher HDL levels. "Further research is needed still, as we have a lot to find out about the real and long-term effects of niacin on the heart and arterial blockages," she says.

She points out that extended-release niacin used in this study is a prescription medication, and that it is not sold over the counter like many other vitamin B products.

Michos, an assistant professor at Hopkins, says that study results, regardless, do not change the fundamental basics of preventing coronary heart disease in the first place. She advocates that people stick with the everyday healthy lifestyle choices, known as the A, B, C, D, E and Fs. She recommends that people focus on Antiplatelet drug therapy (such as taking daily aspirin if they are at high risk), monitor Blood pressure and cholesterol levels (taking drugs, as needed to control it), keeping tabs on blood cholesterol levels and never smoking or Ceasing to smoke, watching their Diet to avoid weight gain, Exercising regularly, and knowing their Family history for developing such potentially fatal heart disease.

Source: Johns Hopkins Medical Institutions