Vitamin pills may protect against heart attacks

Cholesterol famously comes in two versions – the good and the bad. Heart health, we’re told, depends on lowering the bad (LDL) cholesterol, and pushing up the good (HDI).

But it’s no longer that simple. Bad cholesterol turns out to be part of a double act.

What’s more, this discovery suggests that a new treatment for heart disease could be a simple vitamin tablet.

Doctors have known for some time that people with a high level of Lp(a), as it is known, were more likely to have a heart attack or a stroke.

What wasn’t certain was whether it could cause them or whether it was an innocent bystander.

Now, researchers have found a definite link between higher levels of lp(a) and cardiovascular problems.

The good news is that it seems to respond to a number of different vitamins and supplements, the best known of which is the B vitamin niacin.

‘Niacin is a fantastic all-round treatment for protecting hearts,’ says Dr Sarah Jarvis, of the royal College of GPs. ‘It brings down both LDL and Lp(a) and it also pushes up HDL.’

Is found naturally in liver, poultry and fish, although the best sources are wholegrains, nuts and dried beans. However, patients who are treated with niacin are usually given a 2g supplement a day – far more than you could get from food.

The problem with niacin supplements says Dr Jarvis, is the side-effect of ‘flushing’, in which the blood vessels dilate, making the skin blush and prompting a burst of warmth: ‘Most patients can’t tolerate it because it makes you flush very strongly. I get few repeat prescriptions with niacin.’

However, there is a new form of niacin that could get round this. Tredaptive has an added ingredient that blocks the chemical in niacin that normally causes flushing. (Tredaptive is now available on the NHS.)

But niacin isn’t the only vitamin to bring down Lp(a). According to some clinicians, it also responds to other familiar supplements, such as vitamin C and fish oil.