Too much vitamin B3 may contribute to heart disease, study finds

Evan Walker
Evan Walker TheMediTary.Com |
A person cooking diced chcicken breast in a pan, which is a good source of vitamin BShare on Pinterest
Consuming too much niacin may be bad for the heart. Anjelika Gretskaia/Getty Images
  • There are several non-modifiable and preventable risk factors for heart disease.
  • Researchers recently found that high levels of a common B vitamin called niacin in the body may contribute to cardiovascular disease.
  • They saw that excess niacin can trigger vascular inflammation, which in turn may lead to atherosclerosis — or plaque buildup on artery walls.

About 20.5 million people around the world died from cardiovascular disease in 2021, making it responsible for a third of all deaths globally.

While there are some unmodifiable risk factors for heart disease, including gender, family history, and ethnicity, there are several preventable causes for cardiovascular disease, including obesity, high cholesterol levels, high blood pressure, smoking, eating an unhealthy diet, and not getting enough physical activity.

Now, researchers from the Cleveland Clinic Lerner Research Institute have added to the list of potentially modifiable risk factors with a new study reporting high levels of a common B vitamin called niacin in the body may contribute to cardiovascular disease.

The study was recently published in the journal Nature Medicine.

For this study, Dr. Hazen and his team studied the fasting plasma from about 1,100 people with stable cardiac health.

Upon analysis, researchers discovered that higher circulating levels of N1-methyl-4-pyridone-3-carboxamide, or 4PY, were strongly associated with the development of a heart attack, stroke, or other unHealthy cardiac events.

“Our studies found high levels of 4PY in the blood predict future cardiac disease. These new studies help identify a new pathway that contributes to heart disease,” Dr. Hazen said.

However, Dr. Hazen said the main takeaway for readers is not that we should cut out our entire intake of niacin — that’s not a realistic or healthy approach.

OTC niacin supplements

“Given these findings, a discussion over whether a continued mandate of flour and cereal fortification with niacin in the U.S. could be warranted. Patients should consult with their doctors before taking over-the-counter supplements and focus on a diet rich in fruit and vegetables while avoiding excess carbohydrates.”
— Dr. Stanley Hazen

MNT also spoke with Dr. Cheng-Han Chen, a board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, about this study.

“This study identifies excess niacin, specifically its breakdown metabolite 4PY, as a risk factor for major adverse cardiovascular events such as heart attack and stroke,” Dr. Chen explained.

“While niacin was previously prescribed as a cholesterol-lowering medication, its use has fallen out of favor as multiple studies did not find as much benefit to cardiovascular health as initially thought. This study will put another nail in the coffin for the use of niacin in heart disease.”
— Dr. Cheng-Han Chen

Dr. Chen said more studies need to be performed to better understand the dose relationship between niacin supplementation and cardiovascular disease.

“For now, I would caution against routine intake of niacin supplements in the average person,” he continued. “It may be more difficult, however, to avoid niacin-fortified foods given its ubiquity in the food chain; niacin fortification may need to be examined at a higher level as a matter of public policy.”

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