%0 Journal Article
%T HDL-C Response Variability to Niacin ER in US Adults
%A Jennifer B. Christian
%A Eric J. Olson
%A Jeffery K. Allen
%A Kimberly A. Lowe
%J Cholesterol
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/681475
%X Background. Niacin is the most effective treatment currently available for raising HDL-C levels. Objective. To evaluate if gender and baseline lipid levels have an effect on the HDL-C response of niacin ER and to identify factors that predict response to niacin ER at the 500£¿mg dose. Material and Methods. The change in HDL-C effect between baseline and follow-up levels was quantified in absolute change as well as dichotomized into high versus low response (high response was defined as an HDL-C effect of >15% increase and low response was HDL-C <5%) in a sample of 834 individuals. Results. Both males and females with low HDL-C levels at baseline exhibited a response to treatment in the multivariate model (males, HDL-C <40£¿mg/dL: , 95% CI: 2.36¨C11.39; females, HDL-C <50£¿mg/dL: , 95% CI: 1.84¨C15.79). There was also a significant difference in the mean HDL-C effect between baseline and follow-up HDL-C levels in the 500£¿mg niacin ER dose group for both males (mean HDL-C effect£¿=£¿0.08, ) and females (mean HDL-C effect£¿=£¿0.10, ). Conclusion. Baseline HDL-C levels are the biggest predictor of response to niacin ER treatment for both males and females among the factors evaluated. 1. Introduction High-density lipoprotein cholesterol (HDL-C), also referred to as the ¡°good cholesterol,¡± is a known antioxidant, anti-thrombotic, and antiinflammatory, with properties that promote the removal of cellular cholesterol [1]. Individuals with low HDL-C levels may be at an increased risk of coronary heart disease (CHD) [2], and it has been shown in observational studies that the risk of CHD is reduced by 2%-3% for every 1£¿mg/dL increase in HDL-C [3]. Approximately 16% of adults in the United States have low HDL-C levels (25% of males and 7% of females) [4], while 11% of males and 4% of females of 19 years of age or younger have low HDL-C [5]. Low HDL-C is managed by three classes of dyslipidemic pharmacotherapy: niacin, statins, and fibric acid derivatives. Of these, niacin has been shown to increase HDL-C levels by as much as 35% in higher doses, which makes it the most effective pharmaceutical treatment currently available for raising HDL-C [6¨C9]. In addition, extended-release (ER) high-dose niacin has been shown to significantly reduce carotid atherosclerosis within 12 months among statin-treated individuals with low HDL-C who had either type II diabetes with coronary heart disease or carotid/peripheral atherosclerosis [9]. However, recently published results from the Atherothrombosis Intervention in Metabolic Syndrome with Low HDL Cholesterol/High Triglyceride and Impact
%U http://www.hindawi.com/journals/cholesterol/2013/681475/