Alderman J D, Pasternak R C, Sacks F M, Smith H S, Monrad E S, Grossman W
Charles A. Dana Research Institute, Harvard-Thorndike Laboratory, Beth Isreal Hospital, Boston, Massachusetts 02215.
Am J Cardiol. 1989 Oct 1;64(12):725-9. doi: 10.1016/0002-9149(89)90754-6.
One hundred one patients with coronary artery disease and pretreatment ratios of total cholesterol to high density lipoprotein (HDL) cholesterol greater than 4.0 were treated with niacin, commencing at low dosages (100 to 250 mg twice daily) and gradually increasing the dosage over 4 to 8 weeks to 1,000 mg twice daily. Dosage adjustments were made to minimize side effects. At a mean follow-up duration of 11 +/- 7 months, and a mean dosage of 1,415 +/- 698 mg/day, the group had a 13% reduction in total cholesterol, 31% increase in HDL and 32% decrease in the cholesterol to HDL ratio. A subgroup of 62 patients taking greater than 1,000 mg/day of niacin had an 18% reduction in total cholesterol, 32% increase in HDL and 36% improvement in the cholesterol to HDL ratio. A subgroup of 39 patients taking less than or equal to 1,000 mg/day of niacin had only a 5% reduction in total cholesterol, although a 29% increase in HDL and a 24% decrease in the cholesterol to HDL ratio were recorded. Side effects of niacin were reported in 38% of the patients, but led to discontinuation of therapy in only 4. Niacin can be administered in a fashion that is well tolerated, inexpensive and very effective in improving the cholesterol to HDL ratio.
101例冠状动脉疾病患者，其治疗前总胆固醇与高密度脂蛋白（HDL）胆固醇的比值大于4.0，接受了烟酸治疗，起始剂量较低（每日两次，每次100至250毫克），并在4至8周内逐渐增加剂量至每日两次，每次1000毫克。进行剂量调整以尽量减少副作用。在平均随访期为11±7个月、平均剂量为1415±698毫克/天的情况下，该组患者的总胆固醇降低了13%，HDL增加了31%，胆固醇与HDL的比值降低了32%。62例每日服用烟酸超过1000毫克的患者亚组，其总胆固醇降低了18%，HDL增加了32%，胆固醇与HDL的比值改善了36%。39例每日服用烟酸小于或等于1000毫克的患者亚组，总胆固醇仅降低了5%，尽管HDL增加了29%，胆固醇与HDL的比值降低了24%。38%的患者报告了烟酸的副作用，但只有4例因此停止治疗。烟酸可以以耐受性良好、价格低廉且能非常有效地改善胆固醇与HDL比值的方式给药。
