Niacin and Stroke: The Role of Supplementation and Emerging Concepts in Clinical Practice, a Narrative Review.

Niacin therapy has been a mainstay in traditional secondary prevention of stroke. Supplemental use of niacin has been used to improve lipid panel markers, including lowering low-density lipoproteins and triglycerides, and raising high-density lipoproteins, which have been associated with lower risk for stroke. This supplementation has been supported by earlier studies regarding niacin and its role in reducing cardiovascular risk. However, recent studies have called into question the efficacy of niacin therapy and some studies even show negative effects that are associated with taking supplemental niacin. In the present investigation, review of niacin-mediated benefits to cardiovascular disease and newer research suggesting that niacin may be ineffective with the potential of adverse side effects are summarized. This review further highlights the need for more population-level studies regarding the effects of supplemental niacin use to provide a scientific basis for its therapeutic role in cardiovascular disease, including improvement in lipid panel markers and stroke prevention.