Despite lowering cholesterol ezetimibe was ineffective at improving arterial health. In fact, the more it lowered LDL cholesterol the less effective it appeared to be. The trial, published in the Journal of the American College of Cardiology, involved 363 people, 208 of which completed 14 months of follow up, either given statins plus niacin, or statins plus ezetimibe. Those taking niacin had a significant reduction in artery thickness consistent with improving cardiovascular health, while those on the cholesterol lowering drug did not. Ezetimibe did, however lower LDL cholesterol. In fact, those with the greatest reduction in LDL cholesterol had the greatest increase in arterial thickness. What’s more, the longer a person was on niacin the greater was the reduction in arterial thickness, while the longer a person was on the drug the greater was the increase in arterial thickness.
Apart from showing that high dose niacin is clearly better than ezetimibe this study also implies that lowering LDL cholesterol, the hell bent mission of conventional treatment, has nothing to do with reversal arterial blockage. Niacin is one of the most effective substances for increase HDL cholesterol, sometimes called the ‘good’ cholesterol. Raising HDL and lowering triglycerides (blood fats) is the new, and rightful target of treatment. Niacin needs to be given at a dose of 1000 to 2000mg. At this level it causes blushing and therefore delayed release of non-blushing forms are preferable. I have long since argued that raised cholesterol is just an indicator of poor diet. A study published this month Journal of the American Medical Association in the shows that a sugar rich diet, or a high GL diet, is associated with low levels of the ‘good’ HDL cholesterol and high levels of triglycerides.
The researchers conclude “Although long-term trials to study the effect of reducing added sugars and other carbohydrates on lipid profiles are needed, our data support dietary guidelines that target a reduction in consumption of added sugar.” Another study, this time from Italy, called the EPICOR trial, which involved more than 47,000 people, compared diet with cardiovascular risk over almost eight years. Those women in the top quarter of glycemic load (GL) diets, eg eating the most carbs in the form of fast-releasing sugar and refined foods, had double the risk of coronary heart disease than those in the lowest quarter. This study didn’t find the same association with men. There is no clear reason for the sex differences however it may be that women are more sensitive to the hormonal changes that accompany high GL diets. My Low GL Diet Bible contains a section on reversing cardiovascular disease and risk, including what to do regarding supplements such as niacin. If you’d like to find out more about lowering high cholesterol levels without drugs also see the Special Report on this subject.