Effect of niacin on endothelial function: a systematic review and meta-analysis of randomized controlled trials

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#aged #brachial-artery #cholesterol-ldl #endothelium-vascular #humans

Effect of niacin on endothelial function: a systematic review and meta-analysis of randomized controlled trials

Sahebkar et al., 2014 | Vasc Med | Meta Analysis

Citation

Sahebkar Amirhossein. Effect of niacin on endothelial function: a systematic review and meta-analysis of randomized controlled trials. Vasc Med. 2014-Feb;19(1):54-66. doi:10.1177/1358863X13515766

Abstract

Endothelial dysfunction is an independent predictor of incident atherosclerotic cardiovascular disease (ACVD). Niacin possesses high-density lipoprotein (HDL)-elevating, antioxidant and anti-inflammatory properties, all potentially contributing to the amelioration of endothelial function. However, controversies exist among trials reporting the effects of niacin on endothelium-dependent flow-mediated dilation (FMD) as a reliable surrogate of endothelial function. The objective of this study was to assess the effect of niacin on brachial artery FMD using a meta-analysis of available evidence. MEDLINE and Scopus databases were searched for randomized controlled trials investigating the impact of niacin therapy on brachial artery FMD. Meta-analysis of eligible studies was conducted using a random-effects model. Pooled effects were measured by weighted mean difference (WMD) and 95% confidence intervals (CIs). Quality assessment, and subgroup, meta-regression and sensitivity analyses were conducted using standard methods. Among 596 citations, 19 full-text articles were read and seven were found to be eligible for inclusion. Eligible studies involved 441 subjects comprising 228 in the niacin and 213 in the control groups. Niacin therapy significantly improved FMD (WMD: 1.98%; 95% CI: 0.91-3.05%; p = 0.0003) and this effect was robust in the sensitivity analysis. The effect size was greater in the subgroup of studies administering higher doses of niacin (≥ 2000 mg/day) as well as those studies administering niacin for primary prevention of ACVD. Meta-regression indicated no association between niacin-induced changes in FMD and changes in plasma HDL-cholesterol, low-density lipoprotein-cholesterol or triglycerides. None of the included studies could find any significant effect of niacin on nitroglycerin-mediated dilation. In conclusion, treatment with niacin improves endothelial function.

Key Findings

In conclusion, treatment with niacin improves endothelial function.

Outcomes Measured

  • inflammatory markers

Population

Field Value
Population See abstract
Sample Size 441
Age Range See abstract
Condition See abstract

MeSH Terms

  • Aged
  • Brachial Artery
  • Cholesterol, LDL
  • Endothelium, Vascular
  • Humans
  • Male
  • Middle Aged
  • Niacin
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Vasodilation

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: niacin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09