Harvard Health Letter

Niacin into the void

Failure of HDL cholesterol drug may be this B vitamin's big chance.

Drug companies have been frantically looking for an agent to increase HDL levels. It's a worthy goal — although the fact that their patents on the LDL-lowering statin drugs are expiring may have helped animate the search.

Low HDL levels — less than 40 milligrams per deciliter (mg/dL) for men and less than 50 mg/dL for women — are a major risk factor for heart attack. By some reckonings, each 1 mg/dL increase in HDL results in a 2%–3% reduction in cardiac risk. National guidelines say we all should be shooting for HDL levels of 60 mg/dL or higher, and several studies suggest that keeping HDL levels high may be especially important for women.

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