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Statin Therapy With Niacin And Their Effect On Low Ldl Cholesterol In Patients

1315 words - 6 pages

Cardiovascular disease, specifically coronary heart disease, is the leading cause of mortality in the United States of America.(Tsai, Steffen, Guan, McClelland, Warnick, McConnell, Hoefner & Remaley, 2014). There have many advances in medicine in order to lower the instances of mortality caused from this disease. Aspirin, blood pressure lowering medication, and a statin is the combination administered to patients who have an established case of coronary heart disease (Lafeber, 2013). Statin therapy effects the cardiovascular system in such a way that it lowers the blood lipid and low-density lipoprotein cholesterol levels, reducing coronary events that lead to death (Liao, Hsieh, Hung, ...view middle of the document...

Eligibility standards were that the patient had to be a minimum of 45 years old with prior diagnosis of cardiovascular disease, HDL cholesterol < 40 mg per deciliter (blood) and < 50 mg per deciliter (men and women respectively), and LDL < 180 mg per deciliter (blood). Ineligibility factors included acute coronary syndrome hospitalization, planned re-vascularization procedure within four weeks, or if they had a stroke in the eight weeks prior to the screening. The eligible recruits participated in the study in a time range of four to eight weeks. Those that received the niacin got daily doses at 40 mg to 80 mg of simvastatin with 1500 mg to 2000 mg niacin per day. Those that received the placebo received simvastatin and a matching placebo with 50 mg of immediate release niacin. That small amount was added to guard the identity of the treatment form both participants and investigators.
The standards of eligibility previously stated did leave sufficient probability for age, gender, race, socioeconomic status’, and history of illness. The characteristics of the population measured did not reflect the high probability of varying race and gender. 85.2% were men, and 92.2% were white. Socio-economic status was not considered. The varying ages and histories of illness hid a wide range or representation. The measuring techniques did not indicate whether serum lipid levels were tested following a a 12- 14 hour fast. This could result in invalid data to many because triglycerides may be high and effect LDL and HDL levels (Nigam, 2010). With the total studied population being 3,414 participants, this study seems to be limited in validity to only elderly white males with history of varying vascular diseases.
The efficacy of the study was compromised due to lack of control: 282 (16.4%) patients in the niacin group and 274 (16.2%) from the placebo group met a primary end point (death/ hospitalizations from varying cardiac events). In 24 months the niacin therapy increased the midline HDL cholesterol level from 35 mg/dL to 42 mg/ dL. The triglyceride levels were lowered from 164 mg/dL to 122 mg/ dL, and the LDL cholesterol level was lowered as well (74 mg/dL to 62 mg/dL). Despite lowering LDL cholesterol, triglycerides, and elevating HDL cholesterol levels; the hypothesis was rejected due to an insignificant difference in the amount of cardiovascular events that occurred in the patients.
If the hypothesis were to be found true, a significant breakthrough could be achieved in the leading cause of 597,689 deaths in the USA in 2010 ("Leading causes of," 2012). The public can use this information to be aware of the presence of CVD in the United States and how niacin may help reduce the risks of having a cardiac event prior to establishing a history of cardiac problems. The next step is to design studies with more control and variables within the gender and race characteristics. A redesign of this current study should have its focus on controlling variables...

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