Tolerability and safety of commonly used dietary supplements and nutraceuticals with lipid-lowering effects.
BACKGROUND
Cardiovascular diseases are one of the highest causes of death and disability in industrialized countries, whereas a large portion of patients in primary prevention have cardiovascular disease risk factors that remain uncontrolled. Lifestyle interventions, including dietary supplementation with natural compounds possessing known lipid-lowering effects, are strongly supported by the international guidelines for cardiovascular disease prevention.


METHODS
This review provides insights on issues concerning the safety of the most commonly used dietary supplements and nutraceuticals with demonstrated lipid-lowering actions. Soluble fibers, phytosterols, soy proteins, omega 3 polyunsaturated fatty acids, monakolines, policosanols, berberine and garlic extracts are all discussed and a specific focus has been placed on their pharmacological interactions.


CONCLUSIONS
A relatively large amount of preclinical, epidemiological and clinical evidence has demonstrated the tolerability and safety of the most commonly used dietary supplements and nutraceuticals with demonstrated lipid-lowering action. However, for most supplements and nutraceuticals, no evidence is currently available from long-term trials on morbidity and mortality. Detailed knowledge of specific health risks and pharmacological interactions for each individual compound is needed for the management of frail patients, such as children, the elderly, patients with liver or renal failure, high-risk patients, and patients consuming numerous drugs.
Atherosclerosis and Metabolic Disease Research Unit, Internal Medicine, Aging and Kidney Diseases Department, University of Bologna, S. Orsola-Malpighi Hospital, Via Albertoni, 15, 40138 Bologna, Italy. afgcicero@cardionet.it
Arrigo F G
AF
Cicero
Alienor
A
Ferroni
Sibel
S
Ertek
D000818:Animals; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D019587:Dietary Supplements / Q000009:adverse effects*; D006801:Humans; D000960:Hypolipidemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015201:Meta-Analysis as Topic; D012307:Risk Factors
D000960:Hypolipidemic Agents