This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Several risk factors including high cholesterol contribute to heart disease. We know that lowering triglycerides and raising HDL (protective cholesterol) in men reduces the risk for heart disease. We expect that women will share this same benefit because the combination of high triglycerides and low HDL appears to be a more important risk for heart disease in women. Niacin reduces triglycerides and raises HDL. We also expect to see improvement in markers of inflammation and clot formation and blood vessel health, which we hypothesize should all confer a reduced risk of heart disease in women. Women already taking lipid lowering statin will receive niacin therapy. We will measure blood lipid levels, markers of inflammation and clotting as well as a non-invasive measure of blood vessel reactivity. After 3 months of therapy we will repeat these measures. Female coronary artery disease patients on statin drugs for lipid lowering will be randomized to either Niaspan 1.5gm/day or placebo. The two groups will be compared to determine the following: 1) changes in HDL-C, triglycerides, small dense LDL, VLDL, and Lp(a) levels, and 2) changes in endothelial function and inflammatory markers. We hypothesize that these changes will be independent of the exit LDL-C level and will be related to changes in triglycerides and HDL-C
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