Heart disease is the leading cause of disease-associated death in America. Most patients at risk of heart disease are concerned with keeping cholesterol and lipids at lower levels. However, high-density lipoproteins, or HDL, are often known as “good” cholesterol has been shown to be associated with lower risk of cardiovascular disease.
Researchers believe that the function of high-density lipoproteins, or HDL, is to transport excess cholesterol from the blood back to the liver for elimination. HDL may also remove cholesterol from arterial plaques that may have already formed in arteries. Higher levels of HDL are associated with a lower risk of heart disease.
HDL values can be obtained from a lipid panel that is conducted from a blood sample. According to the American Heart Association, men are at higher risk of heart disease when HDL is less than 40 mg/dL. Women are at increased risk when HDL drops below 50 mg/dL. The optimal level of HDL in both groups is greater than 60 mg/dL.
Medications to Increase HDL
Medications in the drug class known as statins work by lowering the production of cholesterol in the liver, which promotes the removal of cholesterol from the blood stream. Statins have been shown to lower bad cholesterols and moderately increase HDL cholesterol.
Fibrate drugs such as fenofibrate and gemfibrozil are effective at lowering triglycerides and can also increase HDL levels. However, taking niacin appears to have the greatest impact in raising HDL levels, especially when combined with other cholesterol-lowering medications.
Niacin, also known as vitamin B3 has been shown to increase HDL even in patients who do not have hyperlipidemia. The recommended daily allowance of niacin in healthy adults is 14-16mg per day. Niacin is commonly found in many foods including eggs, meat, fish and cereal grains.
Unfortunately, higher doses of niacin are usually required to produce the increased HDL effect. Although higher doses of niacin between 50 mg to 6 g can reduce the risk of heart disease, they can also cause unwanted side effects.
High doses of niacin can cause stomach irritation and ulcers. Taking niacin with food is highly recommended. However, the most common complaint of niacin therapy is flushing in the face and chest area. In order to counteract this side effect, many patients may take an aspirin or non-steroidal anti-inflammatory drug with niacin. In addition, time-released niacin products appear to have less incidence of problematic flushing.
Although available over-the-counter, patients should speak to their physician about prescription niacin as an option to increase HDL. In addition, use of high dose niacin often requires routine monitoring of adverse effects by a health care provider.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.