Nutraceuticals as an Important Part of Combination Therapy in Dyslipidaemia

Author(s): Angelo M. Patti, Peter P. Toth, Rosaria V. Giglio, Maciej Banach, Marcello Noto, Dragana Nikolic, Giuseppe Montalto, Manfredi Rizzo*.

Journal Name: Current Pharmaceutical Design

Volume 23 , Issue 17 , 2017

Abstract:

Several risk factors such as abnormality of lipid metabolism (e.g. high levels of low-density lipoprotein cholesterol (LDL-C), elevated triglycerides and low levels of high-density lipoprotein cholesterol (HDL-C)) play a central role in the aetiology of cardiovascular disease (CVD). Nutraceutical combination together with a cholesterol- lowering action, when associated with suitable lifestyle, should furnish an alternative to pharmacotherapy in patients reporting statin-intolerance and in subjects at low cardiovascular risk.

The present review is focused on nutraceuticals and their synergetic combinations demonstrating a beneficial effect in the management of dyslipidaemia. Several nutraceuticals have been shown to positively modulate lipid metabolism having different functions. Plant sterols and soluble fibres can, for example, decrease the intestinal assimilation of lipids and increase their elimination. Furthermore, berberine and soybean proteins improve the cholesterol uptake in the liver. Policosanols, monacolins and bergamot inhibit hydroxy-methyl-glutaryl coenzyme A reductase (HMGCoA reductase) enzyme action determining the cholesterol hepatic synthesis. Moreover, pomegranate can decrease LDL oxidation and positively affect subclinical atherosclerosis; red yeast rice and berberine play, instead, an important role on endothelial dysfunction and psyllium, plant sterols and bergamot have positive effects on LDL subclasses. To the best of our knowledge, there are no long-term large-scale studies on the anti-atherogenic effect of the nutraceuticals that are available on the market. Thus, further clinical studies should investigate in order to achieve long term tolerability and safety and to provide a better nutraceutical combination tailored to the patient needs.

Keywords: Nutraceuticals, dyslipidaemia, low density lipoprotein cholesterol, carotid, intima media thickness, endothelial dysfunction, cardiovascular risk.

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Article Details

VOLUME: 23
ISSUE: 17
Year: 2017
Page: [2496 - 2503]
Pages: 8
DOI: 10.2174/1381612823666170317145851
Price: $58

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