Nicotinic acid Management

On the other hand, in recent years there has been an increasing role for the use of certain vitamins in the prevention and management of specific diseases. The use of nicotinic acid in hyperlipidemia is an old but still a good example for such use. 

Drugs used to increase HDL levels (fibrates, nicotinic acid, and statins) in otherwise normal people do not have the same effect in patients with Tangier disease. Therefore, it is necessary to identify and treat other risk factors associated with CAD. Exercise, weight reduction, dietary cholesterol and saturated fat reduction, and smoking cessation are the first line in management of low HDL cholesterol. Dietary management with low fat intake is beneficial in reducing the risk for CAD, as well... 

Nicotinic acid and its reduced form, nicotinyl alcohol, have been used for years in attempts to manage peripheral vascular disease. However, nicotinic acid and the alcohol (which is metabolized to the acid) have weak vasodilating activity. At tolerated doses they probably exhibit some activity on dermal blood vessels. The nitrate ester of N-(p-hydrox-yethyl)nicotinamide, nicorandil, was developed in Japan as an antianginal agent. The drug has coronary and peripheral vasodilating properties as well as spasmolytic effects. It thus acts as a classical nitrate. Whether the molecular mechanisms are the same has not been established. 

Shepherd J, Betteridge J, Van Gaal L European (Consensus Panel Nicotinic acid in the management of 4 slipidaemia associated with diabetes and metabolic syndrome a position paper developed by a European Consensus Pinel. CurrMedRes Opin (2005) 21, 5-82... 

Restrepo Valencia, C.A., and Cruz, J., 2008. Safety and effectiveness of nicotinic acid in the management of patients with chronic renal disease and hyperlipidemia associated to hyperphosphatemia [in Spanish]. Nefrologia. 28 61-66. 

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