Cholesterol, High Cholesterol

Niacin adverse reactions and interactions:

• The most common adverse effects of niacin include flushing, hyperglycemia, and hyperuricemia (67,59), which results in about 40% of subjects to discontinue the drug (58).
• Niacin may cause hepatotoxicity in sustained release and immediate release forms, but at a much higher rate when taken in the form of sustained release niacin (67,61). Both forms require monitoring of transaminases.
• Higher creatine kinase levels, uric acid, and insulin (67).
• If switching from immediate to sustained release niacin, begin at a much lower dose. A case report showed that when switching from 3 g/daily of immediate-release niacin to same dose slow-release niacin an individual developed hepatitis (63).
• Niacin has been known to induce overt diabetes (58), increase plasma glucose (65), but has left hemoglobin A1C unchanged (65).
• Niacin may cause fatigue, elevation in liver function tests, hepatotoxicity, gastrointestinal complaints, and acanthosis nigricans (61).
• Niacin administration long term is associated with increased plasma homocysteine levels of 17-55% (66).
• Blood pressure is decreased by use of nicotinic acid (Niacin).

Red wine consumption and the lipid profile:

Red wine both increases HDL cholesterol and decreases LDL cholesterol significantly. It is believed that the increase in HDL cholesterol with drinking alcohol containing beverages are responsible for 50% of red wine’s protective effect from coronary artery disease, and 50% may be due to the polyphenols in red wine which inhibit platelet aggregation (68).