Shah Murad, Aamir Bashir, Rizwan Waseem, Samina Qamar, Hafiz Hamad Ashraf, Amar Lal Ghurbakhshani, Riaz Ahmad Sheikh.
Risk reduction of myocardial infarction by reducing cholesterol, body weight and blood pressure.
Pak J Med Health Sci Jan ;5(2):316-9.

Sedentary life style, blood pressure, old age, alcohol intake, tobacco smoking, abnormal body mass index and dyslipidemia are major risk factors for atherogenesis leading to morbidity and mortality due to myocardial infarction. The research study was planned to observe effects of Nicotinic acid (niacin) on blood pressure, body weight, bad cholesterol; i.e. LDL-cholesterol and good cholesterol; i.e. HDL-cholesterol. It was single blind placebo-controlled research study, which was conducted at Jinnah Hospital, Karachi, from April 2010 to December 2010. Fifty male and female hyperlipidemic patients were included in the research study, among which 25 patients were on placebo as control group, and 25 were on tablet Niacin, 2.25 grams daily, in divided doses for the period of three months. Patients with diabetes mellitus, peptic ulcer, renal disease, hepatic disease, hypothyroidism and alcoholism were excluded from the study. Body weight and blood pressure of patients were recorded at fortnightly visit. LDL-Cholesterol was calculated by Friedwald formula (LDL= TC- (TG/5 + HDL-C). Serum HDL-cholesterol was determined by direct method. Serum cholesterol and triglycerides were estimated by the enzymatic calorimetric method. Data regarding results were expressed as the mean ± SD and “t” test was applied to determine statistical significance of results. A probability value of <0.05 was the limit of significance. Three patients were dropped from the study due to side effects of Niacin. In three months of treatment with 2.25 grams of niacin HDL-cholesterol increased from 36.41±1.96 to 43.70±1.81 mg/dl, which was highly significant change when analyzed statistically. Niacin has decreased LDL-Cholesterol from 182.58±8.74 mg/dl to 119.29±4.08 mg/dl, which was highly significant (P<0.001), when compared statistically by paired “t” test. Overall percentage (%) changes from day-0 to day-90 were 34.66. Triglycerides reduced from 169.64±7.60 to 137.35±6.31 mg/dl, which was highly significant (P value <0.001) reduction in three months. Niacin has also reduced Blood Pressure. Difference between mean values of systolic and diastolic blood pressure at day-0 and day-90 were found highly significant (P<0.001). Body weight was reduced from 66.29±194 kg to 64.79±1.82 kg in three months. This change was significant (P<0.01). We concluded from the research study that niacin decreases blood pressure, body weight and LDL-Cholesterol and increases HDL-cholesterol in primary hyperlipidemic patients.

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