Superko HR, et al. – This study analyzed the role of niacin (nicotinic acid) in the primary and secondary coronary heart disease prevention. As per the inferences of two large clinical event trials in 2011 (AIM–HIGH) and 2014 (HPS2–THRIVE), no superior clinical event benefit of niacin plus statin therapy was obvious compared to statin monotherapy. Patients with elevated LDL–C and triglycerides, and reduced HDL–C are more prone to benefit from niacin prescriptions. Recommended formulation and dose of niacin is one capable of achieving adequate lipoprotein change. Contrary to bedtime dosing of niacin, mealtime dosing may avoid a counter–regulatory hormone response, including catecholamines, due to altered fuel supply potentially leading to unexpected cardiovascular outcomes.