Anti-inflammatory effect is an important property of niacin on atherosclerosis beyond its lipid-altering effects.

Niacin has been used for decades to lower the plasma concentrations of cholesterol, free fatty acids, and triglycerides in humans, and in addition it raises more than any other drug the levels of the protective high density lipoprotein. These effects have been used to treat dyslipidemic states. Trials have shown that treatment with niacin reduces progression of atherosclerosis, and clinical events and mortality from coronary heart disease. The beneficial clinical efficacy of niacin appropriately emphasizes the prominent role of its lipid-altering effects; however, high expression of niacin receptor in a variety of immune cell types, lowering of inflammatory markers, and beneficial impact on adipokines expression could provide rational to the hypothesis that anti-inflammatory effect is also an important property of niacin on atherosclerosis beyond its lipid-altering effects.