Why the Niacin-Statin Study Didn’t Work

I know many of you have heard that the big niacin-statin drug study was halted. U.S. officials pulled the plug on this major National Institutes of Health (NIH) study—18 months early! Their reason? The researchers didn’t find what they’d set out to accomplish.

For their study, NIH recruited 3,400 people at high risk for cardiac events. What the researchers had hoped to learn is that by pairing high-dose niacin to raise HDL (good) cholesterol with a statin drug to lower LDL (bad) cholesterol, they could lower the risk of cardiac events. But what they learned instead is that this combination had no effect on the incidence of heart attacks and strokes.

This is no surprise to me…

Researchers were literally barking up the wrong tree

LDL cholesterol—despite its bad guy reputation—isn’t the cause of cardiac events. In fact, half of all heart attacks and strokes occur in people with perfectly normal cholesterol. So, what’s the real perpetrator in cardiac events? Hands-down, its inflammation.

As I’ve been saying for years, inflammation is a major predictor of heart disease, far more accurate than cholesterol levels. A landmark study showed that people with high blood levels of C-reactive protein (CRP)—one of the principal markers of inflammation—were four times more likely to have heart attacks or strokes and five times more likely to develop cardiovascular disease than people with low levels.

Dr. Paul Ridker, who led the study, estimates that approximately 25 percent of the United States population has elevated CRP levels, but normal to low levels of cholesterol. This means that millions of Americans may be unaware that they are at increased risk for future heart problems, even if they are routinely screened for elevated cholesterol.

This research confirmed what I’d been saying for years, that low-grade inflammation within the body is a fundamental cause of cardiovascular disease. It leads to a weakening and rupture of arterial plaques, which causes heart attacks and strokes.

So, what should you do to protect yourself?

Since C-reactive protein (CRP) plays such an important role in inflammation, it is important to ask your doctor to conduct a test to find out how much CRP is in your blood. While the overall numbers may vary according to the lab, look for a general reading below one. That would be considered normal. Anything above one may indicate silent inflammation.

Studies have shown that people with elevated CRP run two times the risk of dying from a cardiovascular-related problem compared with those who have high cholesterol levels. Combine a high cholesterol burden with markedly elevated CRP and your risk of heart attack and stroke increases by a factor of nine.

If your CRP is high, I recommend any or all of the following: exercise, weight loss, nattokinase (50–100 mg/day), CoQ10 (100–200 mg/day), baby aspirin, omega-3 fish oil (2 grams/day), and vitamin E (200–400 IU/day). But CRP is not the only test that can help you identify whether or not silent inflammation may be a concern.

You also want to have your doctor test your Lp(a) levels, which is a cholesterol particle that can cause inflammation and clogging of the blood vessels. High Lp(a) is usually hereditary. If you know this has been a problem for your family, you should ask your doctor to perform this test.

If both your CRP and Lp(a) levels are high, I recommend further testing for ferritin, fibrinogen, and homocysteine. All of these markers indicate the presence of inflammation in the body.

To your health,

Dr Sinatra
Stephen Sinatra, M.D., F.A.C.C., F.A.C.N.

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