Abstract
Niacin has long been used as an effective lipid-altering therapy, particularly for raising HDL-C and lowering triglyceride levels. In addition, niacin modestly lowers LDL-C levels. LDL-C circulates in the blood as a heterogeneous population of various sized particles, with smaller LDL particles widely considered to be more closely associated with atherosclerosis and coronary heart disease. Recent evidence suggests that it is the total number of circulating LDL-C particles of various sizes that most closely predicts atherosclerosis risk. This review focuses on the growing body of literature suggesting that niacin favorably alters the number of circulating LDL particles of various sizes.