Nicotinic acid is a vitamer of niacin that can prevent the development of pellagra. This is its essential function, and this effect is attributed also to nicotinamide, which also shares vitamer activity under the niacin group. Beyond its role as a vitamin, nicotinic acid also has a pharmacological profile when taken in higher amounts beyond its requirements for its role as a vitamin. These pharmacological effects include the ability to lower levels of certain lipids in the blood. In particular, nicotinic acid can lower levels of low-density lipoprotein (LDL) cholesterol, triglyceride, and lipoprotein(a), while raising levels of increasing high-density lipoprotein (HDL). Clinical studies suggest that use of niacin to control elevated levels of blood lipids can improve the health of the individual with regard to the cardiovascular outcomes expected. However, nicotinic acid is associated with elevated levels of blood glucose and so the use of high intakes is recommended only for those at high risk of cardiovascular disease, and should also only be taken over the short term under medical supervision. For most people this will not be necessary, as switching to a healthy, high quality diet in itself will be enough to lower blood lipid levels to the normal range. One part of this is that high quality diets cause weight loss, and as weight gain is associated with increased levels of blood lipids and an increased risk of cardiovascular disease, weight loss alone can be a significant part of cardiovascular health.
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