Cicero Arrigo F G, Colletti Alessandro
a Medical and Surgical Sciences Department , University of Bologna , Bologna , Italy.
Expert Opin Drug Saf. 2018 Mar;17(3):303-313. doi: 10.1080/14740338.2018.1429404. Epub 2018 Jan 29.
Cardiovascular diseases (CVDs) are the leading cause of mortality and disability in developed countries, whereas a large portion of patients in primary prevention have uncontrolled level of CVD risk factors. Dietary supplementation with bioactive natural compounds with demonstrated lipid-lowering effects is currently supported by the international guidelines for CVD prevention and some international expert panels.
This review provides insights on issues concerning the tolerability and safety of the most commonly used nutraceuticals with demonstrated lipid-lowering effect in humans. They will be then divided into three main categories according to their mechanism of action (cholesterol synthesis inhibitors, intestinal cholesterol absorption inhibitors, and LDL-C excretion stimulants) and their pharmacological profile will be discussed.
A growing body of preclinical, epidemiological and clinical evidence has defined the tolerability and safety profile of the most commonly used lipid-lowering nutraceuticals. In the most part of cases, the side effects are mild and reversible. However, detailed knowledge of specific health risks and pharmacological interactions for each individual compound is needed for the management of frail patients, such as children, elderly, patients with liver or renal failure, and patients consuming numerous drugs.
心血管疾病（CVDs）是发达国家死亡和残疾的主要原因，而在一级预防中，很大一部分患者的心血管疾病风险因素水平未得到控制。目前，国际心血管疾病预防指南和一些国际专家小组支持使用具有降血脂作用的生物活性天然化合物进行膳食补充。
本综述对人类中最常用的具有降血脂作用的营养保健品的耐受性和安全性问题提供了见解。然后将它们根据作用机制分为三大类（胆固醇合成抑制剂、肠道胆固醇吸收抑制剂和低密度脂蛋白胆固醇排泄刺激剂），并讨论其药理学特征。
越来越多的临床前、流行病学和临床证据已经明确了最常用的降血脂营养保健品的耐受性和安全性。在大多数情况下，副作用是轻微且可逆的。然而，对于儿童、老年人、肝肾功能衰竭患者以及服用多种药物的患者等体弱患者的管理，需要详细了解每种化合物的特定健康风险和药物相互作用。
