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The Role of Nutraceuticals in Statin Intolerant Patients

Maciej Banach, Angelo Maria Patti, Rosaria Vincenza Giglio, Arrigo F G Cicero, Atanas G Atanasov, Gani Bajraktari, Eric Bruckert, Olivier Descamps, Dragan M Djuric, Marat Ezhov, Zlatko Fras, Stephan von Haehling, Niki Katsiki, Michel Langlois, Gustavs Latkovskis, G B John Mancini, Dimitri P Mikhailidis, Olena Mitchenko, Patrick M Moriarty, Paul Muntner, Dragana Nikolic, Demosthenes B Panagiotakos, Gyorgy Paragh, Bernhard Paulweber, Daniel Pella, Christos Pitsavos, Željko Reiner, Giuseppe M C Rosano, Robert S Rosenson, Jacek Rysz, Amirhossein Sahebkar, Maria-Corina Serban, Dragos Vinereanu, Michal Vrablík, Gerald F Watts, Nathan D Wong, Manfredi Rizzo
Journal of the American College of Cardiology 2018 July 3, 72 (1): 96-118
29957236
Statins are the most common drugs administered for patients with cardiovascular disease. However, due to statin-associated muscle symptoms, adherence to statin therapy is challenging in clinical practice. Certain nutraceuticals, such as red yeast rice, bergamot, berberine, artichoke, soluble fiber, and plant sterols and stanols alone or in combination with each other, as well as with ezetimibe, might be considered as an alternative or add-on therapy to statins, although there is still insufficient evidence available with respect to long-term safety and effectiveness on cardiovascular disease prevention and treatment. These nutraceuticals could exert significant lipid-lowering activity and might present multiple non-lipid-lowering actions, including improvement of endothelial dysfunction and arterial stiffness, as well as anti-inflammatory and antioxidative properties. The aim of this expert opinion paper is to provide the first attempt at recommendation on the management of statin intolerance through the use of nutraceuticals with particular attention on those with effective low-density lipoprotein cholesterol reduction.

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