Niacin
ÎÎClinical trials using niacin, alone or in combination with other lipid
medications, have shown benefits in decreasing cardiovascular event
rates and atherosclerosis.
ÎÎThe most common side effect is cutaneous flushing, which is most
significant with the first few doses. The most serious complication of
niacin therapy is dose dependent hepatotoxicity, and therapy should be
accompanied by monitoring of liver function tests. Other side effects of
niacin therapy include impairment or worsening of glucose tolerance and
hyperuricemia.
ÎÎNiacin is contraindicated in patients with active peptic ulcer disease.
n-3 Fatty acids
ÎÎThe long-chain marine omega-3 fatty acids [eicosapentaenoic acid,
C20:5n-3 (EPA) and docosahexaenoic acid, C22:6n-3 (DHA)] lower fasting
and postprandial triglyceride levels in a dose-dependent fashion.
ÎÎSide effects with large doses of omega-3 fatty acids include fishy taste
and burping.
Figure 1. Management of Hypertriglyceridemia
Screen all adults every 5 years
↑ Fasting TGs
Secondary Causes
CV Risk
Family History
Treat
Treat
<1000 mg/dL
Lifestyle
• Diet
• Activity
• Weight Reduction
≥1000 mg/dL
AND
Drugs
• Fibrates (preferred)
• Niacin
• n-3 fatty acids
GOAL
NCEP ATP
Consider
adding statins
