PEDIATRICS Vol. 92 No. 1 July 1993, pp. 78-82
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Niacin Treatment of Hypercholesterolemia in Children

Richard B. Colletti MD1, Nancy K. Roff BS, RN1, Ellis J. Neufeld MD, PhD2, Annette L. Baker RN, MSN2, Jane W. Newburger MD, MPH2, and Timothy L. McAuliffe PhD3

1 From the Department of Pediatrics, University of Vermont College of Medicine, Burlington
2 From the Departments of Cardiology and Medicine, The Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA.
3 From the Department of Medical Biostatistics, University of Vermont College of Medicine, Burlington

Objective. To determine the efficacy and adverse effects of niacin treatment of hypercholesterolemia in children.

Design. Retrospective review.

Setting. Two university hospital referral clinics.

Patients. All children who received single-drug niacin treatment for severe hypercholesterolemia between 1980 and 1991.

Results. Twenty-one children, aged 4 to 14 years, were treated with niacin, 500 to 2250 mg daily. Pretreatment total serum cholesterol value (mean ± SD) was 7.84 ± 1.14 mmol/L (303 ± 44 mg/dL), and low-density lipoprotein cholesterol value was 6.28 ± 1.16 mmol/L (243 ± 45 mg/dL). Niacin treatment in daily doses >1000 mg reduced total cholesterol by 23% and low-density lipoprotein cholesterol by 30% (P < .001) but had no effect on highdensity lipoprotein cholesterol and triglycerides. As in adults, reversible adverse effects were common, occurring in 16 (76%) of the 21 children. Six children (29%) had reversible dose-related elevations of serum aminotransferase levels. Niacin therapy was discontinued in 8 children (38%) because of flushing, abdominal pain, vomiting, headache, or elevated serum aminotransferase levels. Conclusions. This study suggests that although niacin treatment in children is efficacious, adverse effects are common. Until further study demonstrates long-term safety, niacin treatment should be reserved for the closely-supervised treatment of severe hypercholesterolemia by a lipid specialist.

Key Words: cholesterol • hypercholesterolemia • niacin

Submitted on July 6, 1992
Accepted on January 25, 1993




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