Abstract
The aging of the global population and the associated increase in chronic disease burden requires a paradigm shift in how we care for older adults, one that could benefit from exploring a return to nicotinic acid (NA) therapy for dyslipidemia management and niacin supplementation to support healthy aging. Despite the exceptional benefits NA demonstrated in the Coronary Drug Project for improving dyslipidemia, reducing cardiovascular disease (CVD), and enhancing longevity, it has since experienced a significant decline in usage. Several factors have contributed to this decline, including poor dosing and side effect management by providers; poor outcomes of subsequent trials that combined NA with statin drugs that, in retrospect, have been attributed to poor study design; and, a faulty meta-analysis that concluded NA did not significantly reduce CVD. In addition, recent research reveals statins increase the risk of dementia in older persons, and providers are urged to look for alternative ways to manage dyslipidemia. One alternative is NA. This review explains the factors that led to the decline in NA use, provides an overview of the lipid and non-lipid effects of niacin (as NA or nicotinamide) for treating dyslipidemia and other age-related diseases, describes clinical protocols that promote efficacy and patient compliance, and identifies other factors that may contribute to a revival of niacin usage, or a “Niacin Rebirth.”