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Niacin most cost-effective drug for lowering cholesterol.

Niacin Most Cost-Effective Drug For Lowering Cholesterol

Niacin should be used as a first-line cholesterol-lowering medication, provided the niacin is taken with the supervision of a physician, report researchers from the University of Pennsylvania Medical Center.

"One of the surprises in our research is that niacin, the oldest and least-used treatment, is perhaps the cheapest way to lower cholesterol significantly," said Terry Jacobson, M.D., assistant professor of medicine at the University of Pennsylvania Medical Center and a member of the research team. Although niacin is available without prescription, Jacobson cautioned, "patients need to take high doses of niacin to reduce cholesterol and should take it only under the care of a physician."

The National Cholesterol Education Program (NCEP) assumes that high blood-cholesterol levels in most patients can be controlled by diet alone. However, 5 to 10 percent of middle-aged men in the United states will require drug therapy. "While NCEP recommends cholestyramine, colestipol, gemfibrozil, lovastatin, niacin and probucol for these men, the cost-effectiveness of these drugs was not considered when the original drug recommendations were made," said John Eisenberg, M.D., interim chairman of the Department of Medicine and professor of medicine at Penn and an author of the study.

Niacin is the most cost-effective medication for lowering cholesterol, costing $139 per 1 percent reduction. Lovastatin provides the greatest reduction, and at 20 and 40 mg doses its cost-percent reduction is only slightly higher than that of niacin ($177 to $192). The cost per 1 percent reduction for the other agents is approximately two to three times that of niacin. Cholestyramine has the highest ratio ($347), yet is an effective agent in reducing cholesterol. Therefore, niacin and lovastatin were found to be the most cost-effective treatments.

Patients taking niacin and lovastatin must be closely monitored by a physician because both drugs can increase liver enzymes. When the patient begins niacin treatment, blood tests must be done periodically to be certain that the liver enzymes have not increased. Niacin has less serious side effects, such as flushing and itching, but these side effects generally disappear after a few weeks. Niacin is also contraindicated for patients with active ulcer disease, liver disease, gout, and uncontrolled diabetes.

PHOTO : To demonstrate that even on a weekly basis a vegetarian diet can stimulate morale, improve health, and provide motivation, Randy Ellis gives more than 100 homeless people vegetarian meals and, on special occasions, tote bags stuffed with socks, towels and organic food.
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Title Annotation:University of Pennsylvania Medical Center research
Publication:Nutrition Health Review
Date:Mar 22, 1991
Words:408
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