Evidence brief · Supplement
Niacin (B3) for Cardiovascular events
Evidence grade D — AIM-HIGH, HPS2-THRIVE null + harm
- Overall grade
- Grade D
- Last revised
- 1
- graded outcome
- 0
- references listed
Assembled by the app from other entries in this library. It adds no evidence of its own — follow the links to the entries it draws on.
1 at grade D — 1 graded row
What is known
Each outcome with its grade (how strong the evidence is, A to D), the size of the effect where the entry records one, and how often studies agree.
- Cardiovascular eventsEvidence grade D
AIM-HIGH, HPS2-THRIVE null + harm
Trivialhigh
What is uncertain
Read off the same rows as above. Nothing here is added that the entry does not itself record.
- Thin evidence: Cardiovascular events (grade D).
The evidence in words
The verdict
For cardiovascular events, Niacin (B3) earns evidence grade D (trivial effect, high consistency) — the evidence does not support the claim. AIM-HIGH, HPS2-THRIVE null + harm
How it might work
As NAD/NADP it participates in hundreds of reactions. At gram doses nicotinic acid inhibits hepatic VLDL/triglyceride production and raises HDL — an impressive lipid-panel effect that, unusually, did not translate into fewer cardiovascular events.
How to use it
Requirement is milligrams from food. Pharmacologic niacin for lipids is largely abandoned and should only ever be used under a clinician. Nicotinamide 500 mg twice daily is the skin-cancer-prevention protocol in high-risk patients.
Safety & cautions
Nicotinic acid causes prostaglandin-mediated flushing and, at high doses, liver stress and glucose elevation. Do not self-prescribe gram doses.
Bottom line
You need milligrams to avoid deficiency and get them from food. The high-dose 'raise your HDL' era is over — it improved the panel without improving outcomes. Leave pharmacologic niacin to physicians.
How it is used
As the entry records it, from the studies it summarises. Not a recommendation for you — doses that suit a trial population may not suit you.
- Skin (nicotinamide)
- 500 mg twice daily in high-risk patients, under care.
Goes with
- Niacin (B3)Read the full Niacin (B3) monographEvidence grade B
Related reading
Entries that share this one's tags or conditions.
- Niacin (B3) for HDL / triglyceridesEvidence grade A — Strong lipid-panel effectEvidence grade A
- Niacin (B3) for Non-melanoma skin cancer (nicotinamide)Evidence grade B — In high-risk patientsEvidence grade B
- Niacin (B3) for PellagraEvidence grade A — DefinitionalEvidence grade A
- Niacin (B3): dosage and how to take it500 mg twice daily in high-risk patients, under care.Evidence grade B
Sources
This entry lists no references of its own — it is assembled from the entries it links to, whose sources are on their pages.
Last revised . A grade is this entry's reading of the evidence, not medical advice.