Newly Discovered Pathway Links Excess Niacin to Cardiovascular Disease, Study Finds
A groundbreaking study conducted by a team from the Cleveland Clinic has revealed a previously unknown connection between excess niacin (vitamin B-3) and cardiovascular disease. The researchers identified a byproduct of niacin called 4PY, which is found in high levels in individuals with cardiovascular issues. The study, published in Nature Medicine, sheds light on the role of 4PY in increasing the risk of heart attack, stroke, and vascular inflammation, which can lead to atherosclerosis.
The team, led by renowned scientist Dr. Stanley Hazen, discovered that elevated levels of 4PY were strongly associated with the development of adverse cardiac events in large-scale clinical studies. Furthermore, preclinical studies demonstrated that 4PY directly triggers vascular inflammation, causing damage to blood vessels over time. These findings have significant implications for diagnostic and therapeutic approaches in cardiovascular disease.
Dr. Hazen expressed his excitement about the results, stating, “What’s exciting about these results is that this pathway appears to be a previously unrecognized yet significant contributor to the development of cardiovascular disease.” He emphasized the potential for diagnostic testing and the opportunity to develop new approaches to counteract the effects of this pathway.
The study also raises questions about the fortification of staple foods with niacin. For decades, niacin fortification has been mandated in many countries to prevent diseases related to nutritional deficiency. However, the research indicates that approximately one in four individuals may be consuming excessive amounts of niacin, leading to high levels of 4PY and an increased risk of cardiovascular disease.
Dr. Hazen compares the intake of niacin to multiple taps pouring water into a bucket. Once the bucket is filled, it begins to spill over, and the body must process the spill-over and produce other metabolites like 4PY. He suggests that a discussion should be initiated regarding the continued mandate of niacin fortification in the United States.
The study findings also shed light on the diminishing use of niacin as a treatment for lowering cholesterol. Niacin was once prescribed to lower LDL or “bad” cholesterol, but its effectiveness was found to be limited compared to other cholesterol-lowering drugs. Previous research also associated niacin with negative effects and higher mortality rates. Dr. Hazen believes that the newly discovered adverse effects of excess niacin help explain this paradox.
Dr. Hazen advises patients to consult with their doctors before taking over-the-counter niacin supplements and emphasizes the importance of a diet rich in fruits and vegetables while avoiding excess carbohydrates. He notes that broader use of such supplements has become popular due to their presumed anti-aging benefits.
The research conducted by Dr. Hazen’s team is part of an ongoing investigation into factors contributing to residual cardiovascular risk. By following patients over time and analyzing blood samples, the team aims to identify chemical signatures that can predict the development of heart disease. Dr. Hazen has made significant discoveries in atherosclerosis and inflammatory disease research, including the groundbreaking link between gut microbial pathways and cardiovascular disease.
While the study provides valuable insights, the authors acknowledge the need for long-term investigations to assess the effect of chronic elevation of 4PY levels on atherosclerosis and other related conditions.
Dr. Hazen’s pioneering work in cardiovascular research, along with his role as the director of Cleveland Clinic’s Center for Microbiome and Human Health, highlights his dedication to advancing our understanding of cardiovascular disease. The study was supported in part by the National Institutes of Health, reflecting the importance of continued funding for groundbreaking research in this field.
In conclusion, the discovery of a new pathway linking excess niacin to cardiovascular disease represents a significant breakthrough in our understanding of this prevalent health issue. The identification of 4PY as a key contributor to adverse cardiac events opens doors for potential diagnostic testing and the development of targeted interventions. As we reevaluate the fortification of staple foods with niacin, it is crucial to prioritize further research and explore new approaches to reduce the impact of this pathway on cardiovascular health. Dr. Hazen’s groundbreaking study serves as a reminder of the importance of ongoing scientific exploration in the pursuit of improved cardiovascular care.
