Statins and nutraceuticals/functional food: Could they be combined?

Hypercholesterolemia constitutes one of the main cardiovascular risk factors and, consequently, treat it is really important to limit the risk of one of the leading causes of death in developed countries. Therefore, an effective treatment to reduce high cholesterol is necessary: statins have proved to be the gold standard among lipid-lowering drugs, but at the cost of many unpleasant side effects. At the same time, many nutraceuticals or functional foods were identified to lower levels of LDL cholesterol, acting according to different mechanisms of action. Soluble fiber, glucomannan, plant sterols and probiotics inhibit the absorption of cholesterol and biliary salts by the bowel; monacolins, polycosanols, garlic and bergamot inhibit HMG-CoA reductase, limiting the hepatic synthesis of cholesterol; berberine, soy proteins and green tea act as inducers of LDL cholesterol excretion. Clinical trials have shown that these nutraceuticals have an additive effect to statins, allowing to reduce the doses of statins without decreasing the results in terms of effectiveness in reducing total and LDL-cholesterol and significantly limiting side effects. The results of the studies carried out have been encouraging, but further clinical trials prolonged over time are required to better assess the potential and possible long-term side effects of nutraceuticals and their combination with statins.