Effects of nicotinic acid and its derivatives on lipid metabolism and other metabolic factors related to atherosclerosis.

Abstract

Nicotinic acid treatment thus induces several beneficial effects on serum lipoproteins and on hemodynamic factors related to the risk for development of atherosclerosis. It effectively reduces the atherogenic lipoproteins VLDL and LDL and also increases the anti-atherogenic HDL, mainly the HDL2 fraction. The drug seems to be active not only in decreasing the synthesis of various lipoproteins but also to enhance the removal into peripheral tissues, thereby speeding up the catabolic events of serum lipoproteins. The mode of action of NAc in adipose and muscle tissue needs further evaluation to better understand the complex interplay between free fatty acid and glucose and insulin metabolism. The recent findings of a stimulation of prostacyclin formation as well as a reduction in platelet aggregation are newly discovered favorable effects of the drug that needs to be further examined. Although the drug seems to induce some undesirable side effects (reversible), its several favorable anti-atherosclerotic properties should stimulate both experimental and clinical research with this drug. Hopefully newer derivatives with even better tolerance may be developed.