Effects of low-dose of niacin associated to simvastatin in the treatment of mixed dyslipidemia Salgad.

Aim. The aim of this study was to evaluate the effects of low-dose niacin extended-release (niacin-ER) combined with simvastatin (SV) in the treatment of patients with mixed dyslipidemia who have not normalized their lipid profile with statin therapy alone. Methods. A prospective, clinical trial of 35 patients with mixed dyslipidemia who were treated with niacin-ER and SV. The dosage administrated were 250 mg niacin-ER plus 10 mg SV in the first two weeks, 500 mg/20 mg in the next two weeks, and 750 mg/20 mg in the final four weeks. Patients received 200 mg of acetylsalicylic acid 30 minutes before each drug administration. Results. There were significant increases of apolipoprotein A-I and HDL; and decrease of apolipoprotein B, LDL, triglycerides, and total cholesterol. There was low frequency of flushing (10%) and no worsening in the control of fasting and postprandial glycemia and glycated hemoglobin. Conclusions. Low-dose niacin-ER associated to simvastatin may be useful for achieving improvement in lipid profile or even to achieve the targets recommended for prevention of cardiovascular disease. Other advantages are the low frequency of flushing, which improved adherence to treatment, and no worsening of insulin resistance in patients with or without diabetes mellitus.