Elevated levels of a common vitamin previously recommended to lower cholesterol are linked to processes in the body that contribute to heart disease, a new study has found.

Researchers have found a link between high levels of vitamin B-3, a breakdown product of excess niacin, and heart disease.

They also discovered that this breakdown product, 4PY, can cause vascular inflammation, damage blood vessels, and lead to atherosclerosis, a buildup of fat and cholesterol in artery walls.

The team’s findings pave the way for potential interventions to stop or reduce this inflammation.

Dr. Stanley Hazen, chief of the Division of Cardiovascular and Metabolic Sciences at the Lerner Institute at the Cleveland Clinic, led the study.

“What is interesting about these results is that this pathway, previously unrecognized, appears to contribute significantly to the development of cardiovascular disease,” he said.

“Furthermore, being able to measure it means there is potential for diagnostic tests. These insights set the stage for developing new approaches to counteract the effects of this pathway.”

For many years, more than 50 countries have added niacin to foods such as flour, cereals, and oats to prevent nutritional deficiencies.

However, Dr. Hazen’s research found that one in four people took too much niacin and had elevated 4PY levels, which appears to be linked to the development of heart disease.

Dr. Hazen said overdosing on niacin is like pouring from several faucets into a bucket at once, and once the bucket is full, it will start spilling.

To deal with the overflow of niacin, the body produces metabolites such as 4PY.

Dr. Hazen cautioned against cutting out niacin completely, but added, “Given these findings, it is important to discuss whether continuing requirements for fortifying flour and grains with niacin in the United States are justified.” There is a need to do so.”

Niacin was one of the original treatments for lowering “bad” cholesterol, LDL.

However, over time, niacin was found to be less effective than other treatments and associated with negative side effects and increased mortality.

Dr. Hazen said: “There has always been something of a paradox in the effectiveness of niacin. Even though niacin lowers cholesterol, the clinical benefit has always been less than expected based on the degree of LDL reduction.

“This led to the idea that excess niacin causes obscure side effects that partially negate the LDL-lowering benefit. We believe that our findings may explain this discrepancy. This shows why investigating residual cardiovascular risk is so important. We learn much more than we set out to find.”

Dr Hazen said over-the-counter supplements containing various types of niacin have become popular in recent years due to their potential anti-aging benefits, and advised people to consult their doctor first before taking such supplements. did.

Read the full study in Nature Medicine.