AIM HIGH simply shows what I published 10 years ago in J Cardiovasc Risk,2000; 7: 415-423.  When LDL is low enough, HDL is immaterial.  By low enough, I mean anywhere lower than 80 mg/dl (2.0 mmoles/L).  Under such circumstances, angiographic stabilization/regeression of coronary artery plaque occurs in 93% of cases.  When plaques stabilize or regress, atherothrombotic disease (ATD) events fall dramatically.  This has been my experience over the last 10 years.  While I personally do not prescribe Niaspan due to its itching and flushing effects, I should think that if LDL levels exceed 80 mg/dl and if HDL is low (39 mg/dl [1.0 mmoles/L or less),  I personally would have no problem with physicians prescribing Niaspan.  I disagree with Dr Bilazarian about fibrates, though I do think that they should only be used when HDL is low and TG are high.  The prediction of the populatiuon at risk of ATD is published in Experimentqal and Clinical Cardiology, 2004;9(4): 235-241.

Incidentally, remember that the above goals are based on the indirect measurement of HDL.  Tahe direct measurement of HDL gives a value about 10 mg/dl (0.25 mmoles/L) higher than the indirect measurement, and hence the LDL value obtained by calculation will be 10 mg/dl lower when HDL is measured by the direct method (JClin Lipid, 2008; 2(5):401-402).