Niacin (nicotinic acid) and heart

What 3 graded rows on niacin (nicotinic acid) agree on for heart, and where they differ. Counted side by side, never averaged.

Consensus finder Rows from the Niacin (nicotinic acid) page, reviewed Oct 21, 2026 How it decides

What the rows agree on

Each block and row is one graded row from the Niacin (nicotinic acid) page, with its PubMed record.

Supplement

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3 rows · 68,282 people

They agree: all 3 rows found no difference.

No difference

Improved

Each block is one evidence row, sized by how many people it enrolled, with its grade inside.

From the rows

Every row is graded No effect, our grade for adequately powered trials that found no effect.

The rows run from 3,414 to 39,195 people, published from 2011 to 2017: 1 pooled review and 2 single studies.

3 no difference

No effectMortality, heart attack and stroke · No difference
Meta-analysis, 23 studies · n 39,195 · 2017 · Adults with or without cardiovascular disease in 23 RCTs (median 48% with prior MI)
Median 2 g/day · Median 11.5 months
No reduction in overall mortality (RR 1.05), cardiovascular mortality (RR 1.02), heart attacks (RR 0.93) or strokes (RR 0.95).
Row on the Niacin (nicotinic acid) page · PubMed 28616955 (opens PubMed)
No effectMajor vascular events on top of statins · No difference
RCT · n 25,673 · 2014 · Adults with vascular disease on statin therapy
2 g/day niacin + 40 mg laropiprant · Median 3.9 years
Major vascular events 13.2% vs 13.7% (rate ratio 0.96); excess serious diabetes complications (+3.7 points), new diabetes (+1.3), GI, muscle, skin, infection and bleeding events.
Row on the Niacin (nicotinic acid) page · PubMed 25014686 (opens PubMed)
No effectCardiovascular events with intensive statin therapy · No difference
RCT · n 3,414 · 2011 · Adults with atherosclerotic disease and low HDL on simvastatin
1,500–2,000 mg/day · Mean 3 years (stopped early)
HDL rose from 35 to 42 mg/dL and triglycerides fell, but the primary endpoint occurred in 16.4% vs 16.2% (HR 1.02).
Row on the Niacin (nicotinic acid) page · PubMed 22085343 (opens PubMed)