Wouldn’t it be great if each of us could improve our cholesterol level and prevent a heart attack just by taking a vitamin? No more worries about diet and exercise. No more hassles of seeing a cardiologist, having an angioplasty, or undergoing open-heart surgery.

Of course, that’s not realistic. A patient whom I saw this week brought in a bag filled with exotically named vitamins purchased from obscure manufacturers. These vitamins are of dubious value, certainly not proven and not worth the millions of dollars spent on them. Since the kidneys mostly secrete these products, it’s safe to say that he had very expensive urine.

Unlike prescription drugs, the Food and Drug Administration does not regulate vitamins or nutritional supplements. Buyers have no assurance that they are even taking the contents on the label. One way to minimize the risk is to only buy from large manufacturers, like Upsher-Smith or Bayer.

One vitamin stands alone in its ability to reduce build up of arterial plaque and reduce the risk of heart attacks. Niacin, vitamin B3, has been studied for decades and has been proven to lower LDL (lousy or lethal) cholesterol levels, raise HDL (helpful or healthy) cholesterol levels, and lower triglyceride levels.

Niacin has a long history. In the mid 1960s the Coronary Drug Project investigators studied Niacin and found that patients taking it had slightly fewer heart attacks. However, niacin did not catch on as a treatment for three major reasons.

First, Niacin causes flushing in the majority of patients. This side effect can be lessened by taking Niacin with a meal and taking a full strength aspirin one hour before taking Niacin. Second, as Niacin is a vitamin, companies had no reason to fund more studies or to promote its use. Third, statins such as Lipitor, Zocor and Crestor became enormously popular and Niacin faded into the background.

But at the November American Heart Association Meeting, researchers presented their findings about patients taking both Niacin and Zocor. These patients had a very low rate of having heart attacks and their carotid arteries actually showed reduction of blockage. This research and other studies show great benefit of combining a statin with Niacin.

Niacin is available over the counter as Slo-Niacin and by prescription as Niaspan. No-flush Niacin is a health food scam as it contains inositol hexanicotinate and does not benefit cholesterol levels.

In conclusion, Niacin can help prevent heart attacks in some patients, but it has side effects and is not for everyone. If you have blockages in your heart arteries ask your doctor if Niacin is appropriate for you.