Department of Hypertension, Medical University of Lodz, and the Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland.
Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
J Am Coll Cardiol. 2018 Jul 3;72(1):96-118. doi: 10.1016/j.jacc.2018.04.040.
Statins are the most common drugs administered for patients with cardiovascular disease. However, due to statin-associated muscle symptoms, adherence to statin therapy is challenging in clinical practice. Certain nutraceuticals, such as red yeast rice, bergamot, berberine, artichoke, soluble fiber, and plant sterols and stanols alone or in combination with each other, as well as with ezetimibe, might be considered as an alternative or add-on therapy to statins, although there is still insufficient evidence available with respect to long-term safety and effectiveness on cardiovascular disease prevention and treatment. These nutraceuticals could exert significant lipid-lowering activity and might present multiple non-lipid-lowering actions, including improvement of endothelial dysfunction and arterial stiffness, as well as anti-inflammatory and antioxidative properties. The aim of this expert opinion paper is to provide the first attempt at recommendation on the management of statin intolerance through the use of nutraceuticals with particular attention on those with effective low-density lipoprotein cholesterol reduction.
他汀类药物是治疗心血管疾病患者最常用的药物。然而，由于他汀类药物相关的肌肉症状，在临床实践中坚持他汀类药物治疗具有挑战性。某些营养保健品，如红曲米、佛手、小檗碱、朝鲜蓟、可溶性纤维、植物甾醇和甾烷醇，单独或联合使用，以及与依折麦布联合使用，可被视为他汀类药物的替代或附加治疗方法，尽管关于它们在心血管疾病预防和治疗方面的长期安全性和有效性的证据仍然不足。这些营养保健品可能具有显著的降脂活性，并可能具有多种非降脂作用，包括改善内皮功能障碍和动脉僵硬，以及抗炎和抗氧化作用。本专家意见文件的目的是首次尝试通过使用营养保健品来管理他汀类药物不耐受，特别关注那些具有有效降低低密度脂蛋白胆固醇作用的营养保健品。
