Niacinamide for High Blood Pressure & CVD

Niacinamide, also known as nicotinamide or vitamin B3, is a water-soluble vitamin that plays a vital role in many biological processes in the body. It is an essential nutrient that our body needs but cannot produce on its own, so we need to obtain it from our diet or supplements.

Niacinamide is a precursor to two important coenzymes in the body: nicotinamide adenine dinucleotide (NAD+) and nicotinamide adenine dinucleotide phosphate (NADP+). These coenzymes are involved in many metabolic processes, including the breakdown of carbohydrates, fats, and proteins to produce energy, DNA repair, and cell signalling.

Niacinamide has many potential health benefits. It may help to reduce inflammation and oxidative stress in the body, which is implicated in many chronic diseases, including cancer, heart disease, diabetes and of course kidney disease. It may also help to improve skin health by reducing inflammation, promoting collagen synthesis, and reducing hyperpigmentation.

Niacinamide is found naturally in many foods, including meat, fish, and poultry, as well as in some plant-based sources such as mushrooms, avocados, and peanuts. It is also available as a dietary supplement in various forms, including capsules, tablets, and powders.

Heart Disease

Niacinamide has been studied for its potential role in preventing and treating cardiovascular disease. Heart disease, including coronary artery disease, is a leading cause of death worldwide, and there is a need for effective and safe treatments to prevent and manage this condition.

One way in which niacinamide may benefit heart health is by improving lipid metabolism. Lipids are fatty substances that are an essential component of our cells, but high levels of certain types of lipids, such as LDL cholesterol, can contribute to the development of atherosclerosis, a process in which fatty deposits build up in the arterial walls and can lead to heart attack and stroke. 

Studies have shown that niacinamide can increase HDL cholesterol levels, which is known as “good” cholesterol because it helps to remove LDL cholesterol from the bloodstream and decrease levels of LDL cholesterol and triglycerides, which are a type of fat found in the blood.

Niacin and cardiovascular disease

https://www.researchgate.net/figure/Summary-of-the-effects-of-nicotinic-acid-The-effects-of-niacin-are-mediated-by-its_fig1_309227013/download

Niacinamide’s effect on lipid metabolism is thought to be due to its ability to inhibit the enzyme NADPH oxidase, which is involved in the production of reactive oxygen species (ROS) and inflammation in the arterial wall. ROS can damage cells and contribute to the development of atherosclerosis, so reducing their production may be beneficial for heart health. Additionally, niacinamide has been shown to reduce inflammation and oxidative stress in animal models of heart disease.

In addition to its effects on lipid metabolism, niacinamide may also benefit heart health by improving endothelial function. The endothelium is a layer of cells that lines the interior surface of blood vessels, and it plays an important role in regulating blood flow and maintaining healthy blood vessels. Studies have shown that niacinamide can improve endothelial function and reduce the development of atherosclerotic lesions in animal models of heart disease.

Niacinamide has shown potential for preventing and managing cardiovascular disease through its effects on lipid metabolism, inflammation, and endothelial function. While more research is needed, niacinamide may be a safe and effective addition to a comprehensive approach to heart disease prevention and management.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699630/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145140/

https://www.wjgnet.com/1949-8462/full/v5/i7/210.htm

Blood Pressure

Niacinamide has also been studied for its potential to lower blood pressure. Nitric oxide (NO) is a potent vasodilator that plays a critical role in the regulation of blood pressure. One proposed mechanism by which niacinamide may lower blood pressure is its ability to increase NO production. A study published in the journal Hypertension in 2000 investigated the effects of niacinamide on NO production in hypertensive rats. The study found that niacinamide supplementation increased NO production and reduced blood pressure in the rats. A more recent study published in the Journal of Cardiovascular Pharmacology in 2017 also found that niacinamide supplementation increased NO production in hypertensive rats, which led to a reduction in blood pressure.

Additionally, niacinamide has been shown to reduce oxidative stress and inflammation in animal models of hypertension. Oxidative stress and inflammation can damage the blood vessels and contribute to the development of hypertension. A study published in the Journal of Hypertension in 2014 investigated the effects of niacinamide on oxidative stress and inflammation in hypertensive rats. The study found that niacinamide supplementation reduced oxidative stress and inflammation, leading to improved endothelial function and lower blood pressure. Another study published in the Journal of Nutrition and Metabolism in 2015 investigated the effects of niacinamide on inflammation in patients with metabolic syndrome, a condition that often includes hypertension. The study found that niacinamide supplementation reduced inflammation in the patients, which may have contributed to a reduction in blood pressure.

A randomized, double-blind, placebo-controlled study published in the journal Nutrients in 2019 investigated the effects of niacinamide supplementation on blood pressure in patients with hypertension. The study found that niacinamide supplementation significantly reduced systolic blood pressure and diastolic blood pressure after eight weeks of treatment.

https://journals.lww.com/cardiovascularpharm/Fulltext/2017/04000/Nicotinamide_Reduces_Blood_Pressure_and_Elevates.5.aspx

https://journals.lww.com/jhypertension/Fulltext/2014/02000/Nicotinamide_ameliorates_oxidative_stress_and.21.aspx

https://www.mdpi.com/2072-6643/11/10/2447

Kidney Disease

Niacin has been studied for its potential effects on kidney function and disease. A randomized controlled trial published in the American Journal of Kidney Diseases in 2013 investigated the effects of niacin supplementation on lipid metabolism and inflammation in patients with CKD. The study found that niacin supplementation for 12 weeks improved lipid metabolism and reduced inflammation in the study participants. 

Another randomized controlled trial published in the Journal of Renal Nutrition in 2016 investigated the effects of niacin supplementation on the concentration of cystatin C and albuminuria (excess protein in the urine) in patients with CKD. The study found that niacin supplementation for 8 weeks reduced the concentration of cystatin C and albuminuria in the study participants. Additionally, a randomized controlled trial published in the Clinical Journal of the American Society of Nephrology in 2015 investigated the effects of niacin on albuminuria in patients with CKD. The study found that niacin supplementation for 16 weeks reduced albuminuria in the study participants.

Furthermore, niacin has been shown to have anti-inflammatory effects as I have previously mentioned, which may be beneficial for individuals with kidney disease. A study published in the Journal of Renal Nutrition in 2020 investigated the effects of niacin supplementation on inflammatory markers in patients with CKD. The study found that niacin supplementation for 12 weeks reduced levels of several pro-inflammatory cytokines, including interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-alpha), in the study participants.

https://www.science.gov/topicpages/h/high+sensitivity+crp

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4716114/

https://pubmed.ncbi.nlm.nih.gov/26598845/

Anti-Inflammatory Actions

Inflammation is a natural response of the immune system to injury or infection, but chronic inflammation can contribute to many diseases, including cardiovascular disease, diabetes, and cancer. Niacinamide has been shown to inhibit the production of pro-inflammatory cytokines, which are molecules that play a key role in the inflammatory response. A study published in the Journal of Investigative Dermatology in 2002 investigated the effects of niacinamide on cytokine production in human skin cells. The study found that niacinamide reduced the production of several pro-inflammatory cytokines, including interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-alpha).

Niacinamide has also been shown to inhibit the activation of nuclear factor kappa-B (NF-kappaB), which is a transcription factor that plays a key role in the regulation of the immune response and inflammation. A study published in the Journal of Biological Chemistry in 2005 investigated the effects of niacinamide on NF-kappaB activation in human keratinocytes. The study found that niacinamide inhibited NF-kappaB activation and reduced the expression of several pro-inflammatory genes.

Additionally, niacinamide has been shown to reduce oxidative stress, which is another factor that can contribute to inflammation. A study published in the Journal of Clinical and Aesthetic Dermatology in 2010 investigated the effects of niacinamide on oxidative stress in patients with moderate to severe acne. The study found that niacinamide reduced oxidative stress and improved skin barrier function in the patients.

Niacinamide has shown potential for its anti-inflammatory effects through inhibition of cytokine production, NF-kappaB activation, and reduction of oxidative stress. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC198552/

https://tahomaclinic.com/Private/Articles2/Niacinamide/Hakozaki%202002%20-%20niacinamide%20on%20reducing%20cutaneous%20pigmentation%20and%20suppression%20of%20melanosome%20transfer.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804877/

https://www.ahajournals.org/doi/full/10.1161/ATVBAHA.109.201129

Anti Oxidant Properties

Antioxidants are substances that can prevent or slow damage to cells caused by free radicals, which are unstable molecules that can damage cells and contribute to the development of many diseases, including cancer, kidney disease, cardiovascular disease, and diabetes. Niacinamide has been shown to increase cellular levels of nicotinamide adenine dinucleotide (NAD+), which is a coenzyme involved in many metabolic processes, including those related to antioxidant defence. 

A study published in the Journal of Biological Chemistry in 2006 investigated the effects of niacinamide on NAD+ levels and oxidative stress in human cells. The study found that niacinamide increased NAD+ levels and reduced oxidative stress in the cells.

Niacinamide has also been shown to increase the activity of various antioxidant enzymes, including superoxide dismutase (SOD) and catalase. A study published in the Journal of Cosmetic Dermatology in 2013 investigated the effects of niacinamide on the antioxidant enzymes SOD and catalase in human skin cells. The study found that niacinamide increased the activity of both enzymes, which led to a reduction in oxidative stress and DNA damage in the cells.

In addition to its effects on NAD+ and antioxidant enzymes, niacinamide has been shown to directly scavenge free radicals and reduce lipid peroxidation. A study published in the Journal of Investigative Dermatology in 1996 investigated the effects of niacinamide on lipid peroxidation and antioxidant activity in human skin cells. The study found that niacinamide reduced lipid peroxidation and increased antioxidant activity in the cells.

Niacinamide has shown potential for its antioxidant effects through increasing NAD+ levels, increasing antioxidant enzyme activity, and directly scavenging free radicals.

https://www.mdpi.com/2076-3921/10/12/1939

https://clinmedjournals.org/articles/jnmdc/journal-of-nutritional-medicine-and-diet-care-jnmdc-2-014.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5962335/

https://pubmed.ncbi.nlm.nih.gov/19473119/

Diabetes

Vitamin B3 (niacin) has been studied for its potential effects on diabetes. Some studies have suggested that niacin may improve glycemic control and reduce the risk of developing type 2 diabetes. 

A randomized, double-blind, placebo-controlled trial published in the Journal of Diabetes and Metabolic Disorders in 2017 investigated the effects of niacin supplementation on blood glucose control and insulin resistance in patients with type 2 diabetes. The study found that niacin supplementation for 12 weeks improved blood glucose control and insulin resistance compared to the placebo group. Another randomized controlled trial published in the Journal of Nutrition and Metabolism in 2012 investigated the effects of niacin supplementation on glucose metabolism and insulin sensitivity in overweight and obese individuals. The study found that niacin supplementation for 12 weeks improved glucose metabolism and insulin sensitivity compared to the placebo group.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373507/

https://heart.bmj.com/content/102/3/198

https://journals.lww.com/md-journal/fulltext/2021/03260/the_efficacy_of_niacin_supplementation_in_type_2.1.aspx

Foods High in Niacin

Here are some foods that are high in vitamin B3 (niacin):

  • Chicken breast
  • Tuna
  • Salmon
  • Turkey
  • Pork (not recommended in later stages of CKD)
  • Beef liver (not recommended in later stages of CKD)
  • Peanuts
  • Mushrooms
  • Green peas
  • Avocado
  • Sunflower seeds
  • Brown rice
  • Whole wheat bread
  • Lentils
  • Potatoes
  • Tomatoes

foods high in niacin

It’s important to note that the amount of B3 in these foods can vary depending on the quality and preparation of the food. Additionally, some people may have difficulty absorbing enough B3 from their diet, so supplementation may be necessary. As always, it’s best to consult with a healthcare provider before starting any new supplement regimen.

Recommended RDA of Niacin

The recommended daily dosage of vitamin B3 (niacin) varies depending on age, sex, and other factors. The following are the recommended dietary allowances (RDAs) for niacin in milligrams (mg) per day:

  • Infants 0-6 months: 2 mg
  • Infants 7-12 months: 4 mg
  • Children 1-3 years: 6 mg
  • Children 4-8 years: 8 mg
  • Children 9-13 years: 12 mg
  • Adolescents 14-18 years: 16 mg (boys) / 14 mg (girls)
  • Adults 19 years and older: 16 mg (men) / 14 mg (women)
  • Pregnant women: 18 mg
  • Breastfeeding women: 17 mg

It’s important to note that these recommendations are based on preventing niacin deficiency and may not be sufficient for individuals with certain health conditions or increased niacin requirements. Additionally, niacin can cause side effects, such as flushing and itching, at high doses, so it’s important to consult with a healthcare provider before taking niacin supplements.

Symptoms of Niacin Deficiency

A deficiency in vitamin B3 (niacin) can lead to a condition called pellagra. The signs and symptoms of pellagra include:

  1. Dermatitis: A skin rash that may be scaly or dark in colour and typically appears on areas of the body exposed to the sun, such as the face, neck, arms, and legs.
  2. Diarrhea: Frequent loose or watery bowel movements that can lead to dehydration and electrolyte imbalances.
  3. Dementia: Confusion, memory loss, and disorientation.
  4. Depression: A persistent feeling of sadness, hopelessness, and/or lack of interest in activities.
  5. Glossitis: Inflammation of the tongue, which can cause it to become red, swollen, and painful.
  6. Fatigue: Feeling tired or weak, even after getting enough sleep.
  7. Headache: A persistent or recurring pain in the head.
  8. Loss of appetite: A reduced desire to eat, which can lead to weight loss and malnutrition.

It’s important to note that pellagra is rare in developed countries where fortified foods and supplements are widely available. However, it can occur in individuals with certain health conditions or who follow restrictive diets, such as those with alcoholism, anorexia nervosa, or Crohn’s disease. 

In addition to the signs and symptoms of pellagra, a mild deficiency in vitamin B3 (niacin) may cause other symptoms. These can include:

  1. Weakness and fatigue: A general feeling of being tired and weak, even after getting enough sleep.
  2. Headaches: A persistent or recurring pain in the head.
  3. Irritability: Feeling easily frustrated, anxious, or stressed.
  4. Poor concentration: Difficulty focusing or remembering things.
  5. Digestive issues: Indigestion, nausea, or abdominal pain.
  6. Skin changes: Dry, itchy, or flaky skin.
  7. Mouth sores: Painful sores or ulcers inside the mouth.
Niacinamide for High Blood Pressure
Niacinamide for High Blood Pressure

Risk Factors For Niacin Deficiency

There are several factors that can cause a deficiency in vitamin B3 (niacin):

  1. Inadequate dietary intake: Niacin is found in a variety of animal-based and plant-based foods, but some people may not consume enough of these foods to meet their daily niacin needs.
  2. Alcoholism: Chronic alcohol consumption can interfere with the body’s ability to absorb and use niacin, leading to a deficiency.
  3. Digestive disorders: Certain digestive disorders, such as Crohn’s disease, celiac disease, and ulcerative colitis, can impair the absorption of nutrients, including niacin.
  4. Medications: Some medications, such as isoniazid (used to treat tuberculosis) and certain cholesterol-lowering drugs, can interfere with the body’s ability to use niacin.
  5. Malabsorption syndromes: Some rare genetic disorders, such as Hartnup disease, can impair the body’s ability to absorb niacin.
  6. Increased metabolic demands: Certain conditions, such as pregnancy, lactation, and hyperthyroidism, can increase the body’s need for niacin.

Potential Drug Interactions

Niacin may interact with the following medications. 

  1. Blood thinners: Niacin can increase the risk of bleeding when taken with blood thinning medications, such as warfarin (Coumadin), aspirin, and clopidogrel (Plavix).
  2. Diabetes medications: Niacin can affect blood sugar levels and may interact with diabetes medications, including insulin and oral hypoglycemic agents.
  3. Cholesterol-lowering medications: Niacin can enhance the cholesterol-lowering effects of medications such as statins and bile acid sequestrants, but may also increase the risk of side effects.
  4. Blood pressure medications: Niacin may interact with blood pressure medications, such as calcium channel blockers and ACE inhibitors, and may cause a sudden drop in blood pressure.
  5. Gout medications: Niacin can increase the level of uric acid in the blood, which may interact with gout medications, such as allopurinol and probenecid.

It’s important to talk to a healthcare provider before taking niacin supplements or changing any medication regimens to avoid any potential drug interactions.

Niacin, B3, is a fantastic supportive nutrient to add to your routine if you have cardiovascular or diabetes-induced Kidney disease. Always consult with a healthcare practitioner before adding any new supplements to your regime. 

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