Combinations of phytomedicines with different lipid lowering activity for dyslipidemia management: The available clinical data
Abstract
Background Cardiovascular diseases are the primary cause of death and the leading cause of disability in industrialized countries. Dyslipidemia is a major independent and reversible risk factor for these diseases: it is estimated that a reduction of 1 mmol/l (38 mg/dl) of LDL cholesterol is associated with a risk of developing a cardiovascular complication reduced by 25%, a reduction potentially achieved by life-style improvement associated to adequate dietary supplementation with bioactive substances.Aim The aim of this review is to focus on the major phytochemical nutraceuticals combinations supported by clinical trials that have demonstrated positive effects in the treatment of dyslipidemia.Main text There are many nutraceuticals with significant lipid-lowering properties: most of them are used in association with a low dosage, because that permits to reduce the risk of side effects and theoretically to improve efficacy. In fact, natural products with different synergetic lipid-lowering could be combined: they can reduce the absorption of lipids from the bowel and/or increase their excretion (soluble fibers, plant sterols, probiotics), enhance the hepatic uptake of cholesterol (berberine, soybean proteins), inhibit Hydroxy-Methil-Gglutaryl Coenzyme A reductase enzyme and consequently the hepatic synthesis of cholesterol (monacolins, policosanols, allicin, soybean proteins, bergamot); furthermore some products are able to reduce the oxidation of the LDL and increase the thermogenesis and lipid metabolism (chlorogenic acid).Conclusion Rational combinations of nutraceuticals with different lipid-lowering activities, whether associated with an appropriate lifestyle, should provide an alternative to drug treatment in patients in primary cardiovascular disease prevention with mildly added cardiovascular risk and in some statin-intolerant patients.
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Rational combinations of nutraceuticals with different lipid-lowering activities, particularly when associated with an appropriate lifestyle, can provide an alternative to drug treatment in patients in primary CVD prevention with mildly elevated LDL-C and in some statin-intolerant patients.
“Rational combinations of nutraceuticals with different lipid-lowering activities (Fig. 1), particularly when associated with an appropriate lifestyle, can provide an alternative to drug treatment in patients in primary CVD prevention with mildly elevated LDL-C (especially for those not being at their target LDL-C)) and in some statin-intolerant patients [90].”
From Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels? (2021) · cites this paper as [90]
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Self-citationCicero, A. F. G., D’Addato, S., & Borghi, C. (2020) · Nutrients · doi:10.3390/nu12103127 · Cited by 25 · see citing works
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An update on the safety of nutraceuticals and effects on lipid parameters
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Trogkanis, E., Karalexi, M. A., Sergentanis, T. Ν., Kornarou, E., & Vassilakou, T. (2024) · Nutrients · doi:10.3390/nu16101453 · Cited by 16 · see citing works
Physiological Activities of Policosanol Extracted from Sugarcane Wax
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Emerging biologic therapies for hypercholesterolaemia
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Nutraceuticals for Management of Metabolic Disorders
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Nutraceuticals: A Remedy to Various Maladies
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Nutraceuticals: Scientific and Legal Definitions around the World
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Natto Red Yeast Rice Supplement Regulates Lipid Profiles
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- Authors
- Cicero, A. F. G., & Colletti, A.
- Affiliations
- University of Bologna (IT)
- Corresponding author
- Cicero, Arrigo F.G.
- Venue
- Phytomedicine
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 23
- Issue
- 11
- Pages
- 1113-1118
- ISSN
- 0944-7113 (ISSN-L)
- OpenAlex
- W2169299785
- Cited by
- 70
- References
- 69
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 6 · 2023: 5 · 2022: 2 · 2021: 6 · 2020: 11 · 2019: 6 · 2018: 5 · 2017: 11 · 2016: 10
- FWCI
- 8.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Phytomedicine (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Natural Products and Biological Research
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Keywords
- dyslipidemia, nutraceuticals, hypolipidemic activity, phytosterols, soluble dietary fiber, probiotics, berberine, soy protein, monacolins, policosanol, allicin, bergamot, chlorogenic acid, LDL oxidation, HMG-CoA reductase inhibition, cholesterol absorption, statin intolerance, cardiovascular disease prevention, dietary supplementation
- MeSH terms
- Berberine, Biological Products, Cholesterol, Clinical Trials as Topic, Drug Therapy, Combination, Fatty Alcohols, Humans, Lipids, Phytotherapy, Phytosterols, Plant Proteins, Silymarin, Dietary Supplements, Dyslipidemias
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