Fibrate and Niacin

Fibrates and niacin are conventional medications that have long been used for the treatment of dyslipidemia. Clinical studies have shown that fibrates and niacin have lipid-modifying effects. Specifically, fibrates, which are peroxisome proliferator-activated receptor-alpha agonists, affect lipid metabolism. That is, it decreases triglyceride and low-density lipoprotein cholesterol (LDL-C) and increases high-density lipoprotein cholesterol (HDL-C) levels. Moreover, niacin, or vitamin B3, is a water-soluble vitamin that increases HDL-C and decreases LDL-C levels. In the era of statins for stroke and cardiovascular prevention, the role of fibrates and niacin is limited in clinical use. Fibrates were considered beneficial as they prevent cardiovascular events, particularly in individuals with hypertriglyceridemia. However, the effect of these medications in preventing stroke remains unclear based on clinical trials. Also, recent studies have shown neutral results in that the application of combined niacin and statins can prevent stroke and cardiovascular diseases. Hence, in the future, the effect of fibrates and niacin in decreasing the residual risk of stroke and cardiovascular diseases should be assessed.