title: Lowering LDL cholesterol with margarine containing plant stanol/sterol esters: is it still relevant in 2011?
abstract: Recommendations about the use of plant stanol/sterol esters have not been updated since 2001. There have been many developments in medicines for lipid-lowering since 2001. In this review, the use of margarines containing stanol or sterol esters, to lower LDL cholesterol is considered in the 2011 setting. Firstly, there is a brief overview of the effects of the stanols/sterols on LDL cholesterol, which shows that these agents have a modest ability to lower LDL cholesterol, and are not effective in all conditions. Secondly, the relevance of the stanols/sterols in 2010/1 is questioned, given they have not been shown to reduce clinical endpoints, and have no effects on HDL cholesterol or triglyceride levels. Finally, there is a section comparing the stanols/sterols with the present day prescription lipid lowering medicines. Prescription drugs (statins, ezetimibe, and niacin) have a much greater ability to lower LDL cholesterol than the stanol/sterol esters, and also increase levels of HDL cholesterol and decrease levels of triglycerides. The statins and niacin have been shown to reduce cardiovascular clinical endpoints. Except in borderline normo/hypercholesterolemia, prescription drugs should be preferred to stanol/sterol esters for lowering LDL cholesterol in 2011.
authors.affiliation: Discipline of Medical Sciences, Faculty of Science and Technology, Queensland University of Technology, Gardens Point, GPO Box 2434, Brisbane, QLD 4001, Australia. sheila.doggrell@qut.edu.au
authors.forename: Sheila Anne
authors.initials: SA
authors.lastname: Doggrell
mesh_terms: D000924:Anticholesteremic Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D001384:Azetidines / Q000494:pharmacology; D002318:Cardiovascular Diseases / Q000178:diet therapy* / Q000188:drug therapy*; D008076:Cholesterol, HDL / Q000187:drug effects; D008078:Cholesterol, LDL / Q000187:drug effects* / Q000235:genetics; D003920:Diabetes Mellitus / Q000178:diet therapy / Q000188:drug therapy; D000069438:Ezetimibe; D058607:Fibric Acids / Q000494:pharmacology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000178:diet therapy / Q000188:drug therapy; D006938:Hyperlipoproteinemia Type II / Q000178:diet therapy / Q000188:drug therapy; D007410:Intestinal Diseases / Q000178:diet therapy / Q000188:drug therapy; D008052:Lipid Metabolism, Inborn Errors / Q000178:diet therapy / Q000188:drug therapy; D008383:Margarine; D018977:Micronutrients / Q000097:blood; D009525:Niacin / Q000494:pharmacology; D010840:Phytosterols / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D012855:Sitosterols / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D014280:Triglycerides / Q000378:metabolism
chemical_list: D000924:Anticholesteremic Agents; D001384:Azetidines; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D058607:Fibric Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018977:Micronutrients; D010840:Phytosterols; D012855:Sitosterols; D014280:Triglycerides; D009525:Niacin; D008383:Margarine; D000069438:Ezetimibe