I decided to start with the Niacin and gradually start adding the other recommendations that Robert Kowalski recommended in The Blood Pressure Cure.

After much research, I decided to go with the brand

Slo-Niacin Polygel Controlled-Release Niacin, 750 mg, 100 Tablets. I am now on day two of taking the Niacin. I make sure to wait a full 24 hours prior to taking my next dose. I also take it after eating a meal to lesson the chance of stomach upset. On day two, about 4 hours after taking my Slo-Niacin I experienced what is called the Niacin Flush. Wow! It wasn't horrible, but it was very intense for about 15 minutes. I was very flushed, hot all over, and looked as if I was sunburned. It actually only lasted a total of about 30 minutes with the last 15 being no big deal at all.

I think I will try my 3rd dose at bedtime as suggested by Kowalski with an aspirin with food of course. It is said that the flush is not so bad while you are sleeping and shouldn't keep you awake. Being a 3rd shift worker every other week, it will make things interesting trying to take it at bedtime each day. We will see how that goes.

Niacin has been shown to help several conditions that affect your blood pressure,

including high cholesterol, poor blood circulation and atherosclerosis
-- hardening of the arteries. Cholesterol can clog your arteries, and the accumulation can make the walls of your arteries hard. This makes it more difficult for blood to flow freely to your heart and other vital organs, increasing blood pressure. Niacin proves effective in reducing the amount of unhealthy lipids -- low-density lipoprotein cholesterol and triglycerides -- in your arteries and improving the levels of high-density lipoprotein. HDL, the "good" cholesterol, helps
pull triglycerides and LDL out of your bloodstream. This helps improve blood flow and lower blood pressure. Of course, you should discuss this with your doctor prior to beginning a regimen of Niacin. Statin drugs are very harmful to begin with (blood pressure meds and cholesterol reducing meds). My goal is to be off my low dose blood pressure medication completely.

If you take niacin, you may experience flushing -- redness, burning
and tingling in your face and chest. I felt it on my arms, legs, and face and had none in my chest. Taking aspirin 30 minutes before
taking niacin may alleviate flushing. You can also take timed-release
formulas such as the one mentioned above.

How Can I Prevent Niacin Side Effects?

By Jennifer Moll, About.com Guide

Updated January 19, 2009

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Question: How Can I Prevent Niacin Side Effects?

Answer: While nicotinic acid can greatly help to lower cholesterol levels, it also has those typical niacin side effects. This leads many people to wonder how they can prevent the side effects of niacin.

If you’ve ever taken nicotinic acid, a form of niacin, you might be familiar with its side effects, such as flushing, itching, and hot flashes. Although these side effects are pretty common, they can be intolerable to the point that some people stop taking nicotinic acid. The side effects usually subside over a couple of weeks, but in the meantime, they might be very bothersome.

These are some simple tips that might help reduce the side effects experienced by taking nicotinic acid:

· If you are taking an immediate-release form of nicotinic acid, you may want to gradually increase your dose. For instance, if you are supposed to take 500 mg of nicotinic acid a day, take 250 mg the first few days until you are able to tolerate the side effects and gradually increase your dose until you reach the recommended dose each day. This only works for immediate-release products (never cut sustained or extended-release pills in half). Also, you might try to divide your dose throughout the day. In this case, you would take 250 mg twice a day, instead of 500 mg once a day.

· If you are having trouble with side effects, such as flushing or itching, you may take a 325 mg aspirin dose at least 15 to 30 minutes before your nicotinic acid dose. Studies have shown that taking aspirin before your nicotinic acid dose can decrease the flushing and itching associated with nicotinic acid.

· Don’t drink hot beverages (such as coffee and hot tea) or alcohol around the time you take your niacin dose, since these drinks may increase the likelihood of flushing.

· If you are still having trouble tolerating the immediate-release form of niacin, you might want to ask your health care provider about a sustained-release or extended-release form of niacin. These forms of niacin release nicotinic acid into the body gradually and somewhat reduce side effects. There are sustained-release forms available over-the-counter, however, in some cases, they have caused hepatitis. Niaspan is the only extended-release form of nicotinic acid and it is only available by prescription.

· There are also other forms of niacin, such as nicotinamide and inositol hexaniacinate, that are designated as ”flush-free” forms of niacin. Although they may not produce the side effects that nicotinic acid can cause, some studies have shown that these forms of niacin may not be effective in lowering cholesterol.

Before trying any of these tips, make sure your health care provider is aware that you are taking a nicotinic acid product, since some individuals may need to be monitored more closely due to health conditions they may have or medications they are taking.

There is also a new a chemical, laropiprant, designed to lower the side effects associated with nicotinic acid. Laropiprant is not available on the market yet, however tests so far have shown that it promises to lower the incidence of side effects associated with nicotinic acid. It is still undergoing testing.

_Sources:

_{Cefali EA, Simmons PD, Stanek EJ, et al.
Aspirin reduces cutaneous flushing after administration of an optimized
extended-release niacin formulation. Int J Clin Pharmacol Ther. 2007;
45(2):78-88.}

_{Dipiro JT, Talbert RL. Pharmacotherapy: A
Pathophysiological Approach, 6th ed 2005.}