Extended-Release Niacin vs Gemfibrozil for the Treatment of Low Levels of High-Density Lipoprotein Cholesterol

Abstract

THE INVERSE relation of plasma high-density lipoprotein (HDL) levels to coronary heart disease was first noted in the 1950s¹ and was clearly established in the 1970s.^2-4 In epidemiological studies,^2,4-6 low HDL cholesterol (HDL-C) levels have predicted coronary risk as strongly as high levels of low-density lipoprotein cholesterol (LDL-C), and in some studies,² HDL-C was a more significant predictor than LDL-C or total cholesterol.^2,4-6 The hypothesis that treating low HDL-C levels with gemfibrozil can reduce recurrent coronary events was confirmed recently in the US Veterans Administration HDL Intervention Trial (VA-HIT).⁷