Without the White Coat
By Florentino P. Alerta II, M.D.

NIASPAN… HDL (good cholesterol) raiser

It has been always our job in this column to educate the community and the lay person, to bring them information on the newest guidelines in medical practice and the discoveries in the field of medical therapeutics—the new armaments in dealing with diseases and illnesses that confront the community.

In this age and time what we see in our midst is the increasing obesity in our children, we have chubby children who may look cute, but there is a danger that later they will be confonted with problems in dyslipidemia and finally heart disease and diabetes. The Filipino diet may have inherited or pattern itself from the American diet, very rich in fat and cholesterol. We may see a lot of cases of young individuals or adults dying from heart diseases secondary to high cholesterol levels early in life, due to a defective diet high in cholesterol and a lifestyle full of vices like too much alcohol consumption, cigarette smoking and a sedentary life with no exercise at all.

In the practice of medicine, high cholesterol (total) levels are addressed by giving “statins” and if the triglycerides (fats) levels were beyond the normal levels we tend to prescribe what we call “fibrates” and the lipoproteins the HDL (high density lipoproteins, “GOOD Cholesterol, protect against arterial diseases) and LDL (low density lipoprotein or VLDL-very low density, “BAD” Cholesterol, increases the risk of arterial heart diseases) were just part of the big picture of “dyslipidemia”.

Too much “fat” or cholesterol is very bad for us, but cholesterol is a very important constituent of the body cells in the formation of hormones and bile salts, mostly made in the liver from a wide variety of foodstuffs, but primarily from saturated fats.

Cholesterol rich diets like eggs and dairy products are absorbed directly. The cholesterol and fats are circulated or transported around the body as lipoproteins. The rule will always hold that if there is an overwhelming increase in the levels of cholesterol in the body there is that risk of developing atherosclerosis (accumulation of fatty tissue in the inner lining of the arteries), thus the risk of a coronary heart disease or stroke. Studies will show that further risk of coronary heart disease are seen in the increasing levels of  low density lipoproteins(LDL-BAD cholesterol), but high levels of high density lipoproteins(HDL- GOOD cholesterol) is a protection from arterial heart disease.

“Statins” may have lowered the risk of cardiovascular morbidities by 30%, but recent studies prove that nicotinic acid can further reduce the cardiovascular morbidities by a whopping 50%. Nicotinic acid in the form of “NIASPAN” is another addition to the management of lowering the further risk of hyperlipidemia (high cholesterol levels).

Nicotinic acid (Niacin) is a member of the vitamin B complex group that plays a very essential role in the activities of various enzymes in the metabolism of carbohydrates and fats. It is the effect of  Nicotinic acid (NIASPAN) that we are interested in, the raising of HDL levels as we have known is the “GOOD CHOLESTEROL” whose actions is protection from the risk of arterial heart disease. A combination of statins and nicotinic acid had further reduced the risk of cardiovascular morbidity compared to the conventional regiment treatment of dyslipedemia. Raising HDL levels will further show that there is a lowering in the risk of cardiovascular morbidity.

“Global” morbidity  was shown with the increased risk of hypertension, smoking and dyslipidemia (had shown to increase in ages 20 years and above, in the Philippines for the year 2003-2004 for those 20 years and below risk factors are contributed to low LDL, smoking and obesity with a gender ration of 1:8, male:female).

NIASPAN (nicotinic acid or niacin) will surely  improve our survival rate for cardiovascular diseases and help us live a healthier life. SALUTE to MERCK, Inc. bridging the gap in LIPID Management, and bringing us the powerful HDL raiser…NIASPAN (nicotinic acid).