Abstract
This paper will focus on the use of nicotinic acid as a therapeutic option for cardiovascular risk reduction in patients with abnormal glucose metabolism and `atherogenic dyslipidaemia'. This is characterised by low levels of HDL-C, high triglycerides, and preponderance of small, dense LDL particles. Whilst nicotinic acid may increase plasma glucose in some patients, more recent studies show that the effect of nicotinic acid on glycaemic control is minimal in the majority of patients, and that nicotinic acid decreases the risk of cardiac events in patients with elevated fasting glucose, diabetes, or metabolic syndrome.