National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland.
Institute of Rural Health, Lublin, Poland.
Ann Agric Environ Med. 2021 Mar 18;28(1):81-88. doi: 10.26444/aaem/130629. Epub 2020 Dec 2.
Increased serum cholesterol levels constitute one of the main risk factors for cardiovascular diseases. Statins are a major method for reducing the levels which also lower the risk of cardiovascular events. However, these valuable drugs cannot be used in all patients who need them due to contraindications and intolerance. In such cases, help can be sought from nutraceutics that reduce the serum cholesterol concentration. Since there are numerous products of this type available at drugstores, registered as supplements, there seems to be a need to demonstrate their effectiveness in preventing cardiovascular diseases induced by atherosclerosis. In literature, increasingly more attention is drawn to red yeast rice, Armolipid, berberine and bergamot.
This article presents knowledge about these nutraceutics based on clinical studies and expert statements relating to their use. The results of clinical studies and metaanalyses have shown that nutraceutics with cholesterol lowering properties, red yeast rice and Armolipid are the most favourable for reducing cardiovascular events. However, the evidence of benefits of berberine and bergamot is not so conclusive.
Red yeast rice products and Armolipid may be used as an alternative treatment in statin intolerant patients, especially in combination with ezetimibe. These nutraceutics can be also considered, as an adjunct to diet therapy in primary prevention of cardiovascular diseases in patients with mild and moderate hypercholesterolaemia. The opinion of experts on berberine and bergamot is ambiguous.
血清胆固醇水平升高是心血管疾病的主要危险因素之一。他汀类药物是降低胆固醇水平的主要方法,也降低了心血管事件的风险。然而,由于禁忌症和不耐受,这些有价值的药物不能用于所有需要的患者。在这种情况下,可以寻求降低血清胆固醇浓度的营养保健品的帮助。由于药店有大量此类作为补充剂注册的产品,似乎有必要证明它们在预防动脉粥样硬化引起的心血管疾病方面的有效性。在文献中,越来越多的人关注红曲米、Armolipid、黄连素和佛手柑。
本文根据与这些营养保健品的使用相关的临床研究和专家声明,介绍了有关这些营养保健品的知识。临床研究和荟萃分析的结果表明,具有降胆固醇作用的营养保健品,如红曲米和 Armolipid,对降低心血管事件最有利。然而,黄连素和佛手柑的益处证据并不那么确凿。
红曲米产品和 Armolipid 可以作为他汀类药物不耐受患者的替代治疗方法,尤其是与依折麦布联合使用时。这些营养保健品也可以被认为是轻度和中度高胆固醇血症患者心血管疾病一级预防饮食疗法的辅助手段。专家对黄连素和佛手柑的看法存在分歧。