U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Clinical Department of Internal Medicine and Specialistics, Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, University of Campania "L. Vanvitelli", Naples, Italy.
IRCCS SDN, Naples, Italy.
Curr Pharm Des. 2019;25(1):85-95. doi: 10.2174/1381612825666190130101108.
Coronary heart disease (CHD) remains the leading cause of disability and death in industrialized Countries. Among many conditions, which contribute to the etiology and progression of CHD, the presence of high low density lipoprotein-cholesterol (LDL-C) levels represents the major risk factor. Therefore, the reduction of LDL-C levels plays a key role in the management of patients with high or very high cardiovascular risk. Although statins represent the gold standard therapy for the reduction of cholesterol levels, these drugs do not allow to achieve target levels of LDL-C in all patients. Indeed, a significant number of patients resulted intolerants, especially when the dosage increased. The availability of new lipid-lowering drugs, such as ezetimibe and PCSK9 inhibitors, may represent an important alternative or complement to the conventional lipid-lowering therapies. However, long-term studies are still needed to define both efficacy and safety of use of these latter new drugs. Some nutraceuticals may become an adequate and effective support in the management of some patients. To date, several nutraceuticals with different mechanism of actions that provide a good tolerability are available as lipidlowering agents. In particular, the most investigated are red yeast rice, phytosterols, berberine, beta-glucans and soy. The aim of this review was to report recent data on the efficacy and safety of principle hypocholesterolemic drugs available and to evaluate the possible role of some nutraceuticals as support therapy in the management of patients with dyslipidemias.
冠心病（CHD）仍然是工业化国家导致残疾和死亡的主要原因。在导致 CHD 的发病和进展的众多因素中，高浓度的低密度脂蛋白胆固醇（LDL-C）水平是主要的风险因素。因此，降低 LDL-C 水平对于管理高或极高心血管风险的患者至关重要。尽管他汀类药物是降低胆固醇水平的金标准治疗方法，但这些药物并不能使所有患者达到 LDL-C 的目标水平。事实上，相当数量的患者对这些药物不耐受，尤其是当剂量增加时。新型降脂药物（如依折麦布和 PCSK9 抑制剂）的出现可能是对传统降脂治疗的重要替代或补充。然而，仍需要长期研究来确定这些新型药物的疗效和安全性。一些营养保健品可能成为某些患者管理的一种合适且有效的支持手段。迄今为止，已有多种作用机制不同、耐受性良好的营养保健品可用作降脂药物。特别是，研究最多的是红曲米、植物固醇、黄连素、β-葡聚糖和大豆。本文旨在报告现有降脂药物的疗效和安全性的最新数据，并评估一些营养保健品作为支持治疗在血脂异常患者管理中的可能作用。
