Non-Pharmacological Treatment of Hypercholesterolemia

Hypercholesterolemia is a major risk factor for the premature development of cardiovascular diseases (CVD). Many controlled studies undertaken with dietary or pharmacological interventions have demonstrated that reduced plasma levels of total and LDL cholesterol (LDL-C) result in a decreased incidence of CV events. Between the dietary and pharmacological treatment, the non-pharmacological treatment could be considered to be an important alternative for patients in primary prevention with mildmoderate hypercholesterolemia at low-moderate global risk of CVD. However, only some functional food and nutraceutical (i.e., soluble fibers, phytosterols, soy proteins, monacolines of red yeast rice, policosanols, berberine and omega-3 fatty acids) have shown be efficacious, safe and well tolerated, and some (monacolines and omega-3 fatty acids) have been largely studied in long-term randomized clinical trials showing a reduction of CV events (morbidity, mortality).