Sorry folks, conflated cardiac and coronary, that’s not a word, Big Bird!
This study from the “prestigious” New England Journal of Medicine was released today. It arrives at essentially the same conclusion as the recent JAMA article above, ie. that Lipitor (80 mg) is superior to Pravachol (40 mg).
Anyone care to comment on the Niacin alternative.? I do it, but not long enough yet to have any results tested. The skin side effects are a drag, but typically last 5 minutes at most and are mitigated if I don’t let myself get hungry (a detail which I take some joy in seeing to).
By “Coronary Disease” are we laypeople talking about a lotta different kinds of problems? (7 pages of pure reading Bliss)
I used to use a lot of niacin. It had the advantage of being appropriate treatment for essentially any lipid disorder (lowering LDL, raising HDL, and lowering triglycerides) as well as being cheap. And, for a long time, it was the only lipid lowering agent that had been shown to reduce coronary disease (ie. it led to the “hard” endpoint of fewer heart attacks, and not simply to a surrogate endpoint such as a lower LDL level).
More recently, though, drugs of the statin class have also been shown to reduce coronary events. While not as cheap as niacin, some of them are not outrageously priced. Most important, however, is the emprical fact that statins are generally safe and well-tolerated. Niacin has a whole host of side effects ranging from bothersome (flushing) to distressing (heartburn) to serious (causing gout) to dangerous (worsening diabetes control and actual preciptation of diabetes itself). And, since many patients with abnormal lipids also have occult diabetes (or “Syndrome X” aka “The Metabolic Syndrome”), the latter effect is particularly worrisome.
The long acting forms of niacin tend not to cause flushing. The other bad effects still occur. Hepatitis has also been reported with that type of niacin preparation.
Bottom line, IMHO, is that for certain people, niacin is a useful drug. For many, possibly most, its side effects are too bothersome for them to comply with its use, or potentially too dangerous to risk.
What say ye, Qadgop?
Which might explain why the “prison sex” thread has sort of petered out…
WHAT TH- !?!
This, sir, is an outrage.
Seriously, send me your office address/phone# via email and I’ll get you as many reps as you want, with lots of cool pens! 
It’s my user name @yahoo.com