Red Yeast Rice for Hypercholesterolemia JACC Focus Seminar

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:77

Article

Cicero, Arrigo F. G.¹  Fogacci, Federica¹  Zambon, Alberto² 

[1] Univ Bologna, Dept Med & Surg Sci, Bologna, Italy

[2] Univ Padua, Dept Med, DIMED, Padua, Italy

关键词: monacolin K;    nutraceutical;    red yeast rice;    safety;   

DOI  :  10.1016/j.jacc.2020.11.056

来源: Elsevier

【 摘 要 】

The extracts of red yeast rice (RYR) are currently the most effective cholesterol-lowering nutraceuticals. This activity is mainly due to monacolin K, a weak reversible inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, whose daily consumption causes a reduction in low-density lipoprotein (LDL)-cholesterol plasma levels up to 15% to 25% within 6 to 8 weeks. The decrease in LDL-cholesterol is accompanied by a proportional decrease in total and non-high-density lipoprotein cholesterol, plasma apolipoprotein B, and high-sensitivity C-reactive protein. Some trials suggest that RYR use is associated with improvement in endothelial function and arterial stiffness, whereas a long-term study supports its role in the prevention of cardiovascular events. Despite the statin-like mechanism of action, the risk related to 3 to 10 mg monacolin K taken per day is minimal (mild myalgia in previously severely statin-intolerant subjects). RYR could represent a therapeutic tool to support lifestyle improvement in managing mild to moderate hypercholesterolemia in low-risk patients, including those who cannot be treated with statins or other LDL-cholesterol-lowering therapies. (C) 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.

【 授权许可】

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