Common B Vitamin Linked to Heart Disease

A new study links excessive levels of niacin, a common B vitamin, with an increased risk of heart attack, stroke, and other adverse cardiac events.

Niacin (vitamin B-3) is very common in a Western diet as it is found in red meat, poultry, fish, brown rice, nuts, legumes, and other foods.

For decades, the United States has mandated niacin fortification in staple foods such as flour, cereals, and oats to prevent nutritional deficiency.


According to a new study published in Nature Medicine, high levels of 4PY, a breakdown product from excess niacin, may contribute to cardiovascular disease development.

Higher circulating levels of 4PY are strongly associated with the development of heart attack, stroke, and other adverse cardiac events in large-scale clinical studies.

The study revealed that increased 4PY directly triggers vascular inflammation, which damages blood vessels and can lead to atherosclerosis, a thickening of the arteries due to plaque buildup in the inner lining.

Researchers say this previously unrecognized pathway is a significant contributor to the development of cardiovascular disease.

“What’s more, we can measure it, meaning there is potential for diagnostic testing. These insights set the stage for developing new approaches to counteract the effects of this pathway,” Dr. Hazen, Chair of Cardiovascular and Metabolic Sciences at Cleveland Clinic’s Lerner Research Institute and the study’s lead author, said in a statement.

The authors note that cutting the entire intake of niacin is unrealistic. Still, these findings should spark a discussion over the necessity of flour and cereal fortification with niacin in the U.S.

Moreover, the study’s findings may also explain why niacin is no longer a go-to treatment for lowering LDL or “bad” cholesterol.

“Despite niacin lowering of cholesterol, the clinical benefits have always been less than anticipated based on the degree of LDL reduction. This led to the idea that excess niacin caused unclear adverse effects that partially counteracted the benefits of LDL lowering. We believe our findings help explain this paradox,” Hazen said.


The findings can be used to develop new interventions and therapeutics to reduce and prevent vascular inflammation. However, more long-term studies are needed to evaluate the effect of chronic elevation of 4PY levels on atherosclerosis.


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prefix 3 months ago
I find these findings particularly promising. The potential to develop new interventions and therapies aimed at reducing vascular inflammation could have significant implications for improving cardiovascular health. However, it's crucial to acknowledge the need for more extensive, long-term studies to fully understand the impact of sustained elevation of 4PY levels on conditions like atherosclerosis. These studies will provide valuable insights into the potential effectiveness and safety of future treatments. I look forward to seeing further research in this area unfold.