Niacin improves small artery vasodilatory function and compliance in statin-treated type 2 diabetic patients

We investigated the effect of niacin (nicotinic acid prolonged release) on forearm vasodilatory function and arterial compliance in statin-treated type 2 diabetic patients with endothelial dysfunction In a parallel group study, we randomised 15 subjects, with LDL-cholesterol <= 2 5 mmol/L, to niacin (dose titrated to 1500 mg/day over 8 weeks, then maintained for a further 12 weeks) or no additional treatment Niacin increased maximal post-ischaemic forearm blood flow (mean +/- SEM 6 4 +/- 2 4 vs -2 3 +/- 1 2 ml/100 ml/min, p = 0 001) and small artery compliance (1 3 +/- 0 8 vs 2 3 +/- 1 2 ml/mmHg,p = 0 0 1) compared with no additional treatment, but did not alter large artery compliance, blood pressure nor heart rate Niacin decreased serum triglycerides by 47% (p = 004), with no change in LDL-cholesterol, HDL-cholesterol, apolipoprotein (Apo) B- 100 nor ApoA-I (p > 0 05) Adding niacin to statin therapy improves small artery vasodilatory function and compliance in type 2 diabetes This may relate to a decrease in serum triglycerides and/or a direct benefit of niacin on vascular biology