Author(s): Elizabeth Tan, Erwin Faller

Email(s): Philippines eytan@usc.edu.ph

DOI: 10.52711/0974-360X.2022.00044   

Address: Elizabeth Tan1,2, Erwin Faller1,3
1Centro Escolar University, Manila, Philippines.
2University of San Carlos, Cebu City,Cebu, Philippines.
3San Pedro College, Davao City, Davao del Sur, Philippines.
*Corresponding Author

Published In:   Volume - 15,      Issue - 1,     Year - 2022


ABSTRACT:
As cardiovascular diseases are still a major cause of death in most countries, it is still relevant to look into treatment of such diseases. Dyslipidemia is one of the important identified risk factors for cardiovascular diseases. As this is largely driven by lifestyle and diet, it may be difficult to control it with lifestyle modifications alone. Currently, Statins remains to be the mainstay therapy for dyslipidemia but this is also met by problems within certain patient population. The drug may be contraindicated in certain patient groups; some patients tend to not respond to Statins; while certain patients may not tolerate the adverse events. This study looked into available literature on studies done on dyslipidemia using plant-based formulations using randomized clinical trial. Based on the review conducted, there are several plant-based formations with potential to be similar in efficacy to Statins. Some of the plants used are abundant or may be easily sourced. With the increasing popularity of food supplements or nutraceuticals, exploration on the potential of plant-based products is attractive. Despite the promising results of some studies, these will need further investigations and targeting a larger population size. Formulation options may need to be explored also focused on its stability.


Cite this article:
Elizabeth Tan, Erwin Faller. Lipid Lowering Effects of Herbal Supplements: A Review. Research Journal of Pharmacy and Technology. 2022; 15(1):270-8. doi: 10.52711/0974-360X.2022.00044

Cite(Electronic):
Elizabeth Tan, Erwin Faller. Lipid Lowering Effects of Herbal Supplements: A Review. Research Journal of Pharmacy and Technology. 2022; 15(1):270-8. doi: 10.52711/0974-360X.2022.00044   Available on: https://www.rjptonline.org/AbstractView.aspx?PID=2022-15-1-44


REFERENCES:
1.    Young DR, Hivert MF, Alhassan S, et al. Sedentary Behavior and Cardiovascular Morbidity and Mortality: A Science Advisory From the American Heart Association. Circulation. 2016;134(13):e262-e279. doi:10.1161/CIR.0000000000000440
2.    Ji X, Shi S, Liu B, et al. Bioactive compounds from herbal medicines to manage dyslipidemia. Biomed Pharmacother. 2019; 118:109338. doi:10.1016/j.biopha.2019.109338
3.    Hariyanto TI, Kurniawan A. Dyslipidemia is associated with severe coronavirus disease 2019 (COVID-19) infection. Diabetes Metab Syndr. 2020;14(5):1463-1465. doi:10.1016/j.dsx.2020.07.054
4.    Atmosudigdo IS, Pranata R, Lim MA, et al. Dyslipidemia Increases the Risk of Severe COVID-19: A Systematic Review, Meta-analysis, and Meta-regression [published online ahead of print, 2021 Feb 8]. J Clin Exp Hepatol. 2021;10.1016/j.jceh.2021.01.007. doi:10.1016/j.jceh.2021.01.007
5.    Bendor CD, Bardugo A, Pinhas-Hamiel O, Afek A, Twig G. Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity. Cardiovasc Diabetol. 2020;19(1):79. Published 2020 Jun 13. doi:10.1186/s12933-020-01052-1
6.    Wekker V, van Dammen L, Koning A, et al. Long-term cardiometabolic disease risk in women with PCOS: a systematic review and meta-analysis. Hum Reprod Update. 2020;26(6):942-960. doi:10.1093/humupd/dmaa029
7.    Hanmukhe A. Co-relation Study to Assess the Knowledge and Attitude about Consuming Fatty Diet and Blood Cholesterol Level Among Adults in Selected Residential Areas, Bangalore. Asian J. Nur. Edu. and Research 2(4): Oct-Dec. 2012; Page 195-196.
8.    Sweety GJ. Assess the effectiveness of cocoa powder in reducing cholesterol level among the hypertensive clients at the rural area, Medavakkam, Chennai. Asian J. Nursing Education and Research. 2020; 10(3): 260-264.
9.    Alkadasi M., Alshami A., Alhabal H.Y. Study the Relation of Serum Lipids with Body Mass Index Among Students in Zabeed Education Collage, Hudaiadah University, Yemen. Asian J. Pharm. Ana. 5(1): Jan.- March 2015; Page 31-35.
10.    Ch. Nagabhushanam P Ramesh babu, NK Durga Devi, A Vasu, Devala Rao. A Comparative Randomized Study of Guggulu and Atorvastatin Hypercholesterolemia Patients. Research J. Pharmacology and Pharmacodynamics. 2010; 2(2):187-189.
11.    Latif N., Firdous J., Mamat S., et al. Association of Height with Total Cholesterol Level in Young Adults in Assessment of Coronary Heart Disease Risk. Research J. Pharm. and Tech. 2018; 11(3): 836-840.
12.    Verma A., Dubey G., Agrawal A. Biochemical Studies on Serum Hb, Sugar, Urea and Lipid Profile under Influence of Ocimum sanctum L in Aged Patients. Research J. Pharm. and Tech. 5(6): June 2012; Page 791-794.
13.    Carrillo-Larco RM, Benites-Moya CJ, Anza-Ramirez C, et al. A systematic review of population-based studies on lipid profiles in Latin America and the Caribbean. Elife. 2020;9:e57980. Published 2020 Aug 18. doi:10.7554/eLife.57980
14.    Xi Y, Niu L, Cao N, et al. Prevalence of dyslipidemia and associated risk factors among adults aged ≥35 years in northern China: a cross-sectional study. BMC Public Health. 2020;20(1):1068. Published 2020 Jul 6. doi:10.1186/s12889-020-09172-9
15.    Xing L, Jing L, Tian Y, et al. Epidemiology of dyslipidemia and associated cardiovascular risk factors in northeast China: A cross-sectional study. Nutr Metab Cardiovasc Dis. 2020;30(12):2262-2270. doi:10.1016/j.numecd.2020.07.032
16.    Hatma RD. Lipid profiles among diverse ethnic groups in Indonesia. Acta Med Indones. 2011;43(1):4-11.
17.    Dodson DJ, Hooton TM, Buchwald D. Prevalence of hypercholesterolaemia and coronary heart disease risk factors among southeast Asian refugees in a primary care clinic. J Clin Pharm Ther. 1995;20(2):83-89. doi:10.1111/j.1365-2710.1995.tb00633.x
18.    NCD Risk Factor Collaboration (NCD-RisC). Repositioning of the global epicentre of non-optimal cholesterol. Nature. 2020;582(7810):73-77. doi:10.1038/s41586-020-2338-1
19.    Ross MC, Duong D, Wiggins SD, Daniels S. Descriptive study of hypercholesteremia in a Vietnamese population of the Gulf coast. J Cult Divers. 2000;7(3):65-71.
20.    L.K. Kanthal, P Mondal, D Saha, D Mridha, S Mandal. New Frontiers on Hyperlipidemia in Pharmaceutical Education. Research J. Pharmacology and Pharmacodynamics. 2010; 2(4): 257-260.
21.    Jadhav K., Kapare P., Khairmode D.,et al. Genetic Insights of Cholesterol and Atherosclerosis: Complex Biology. Asian J. Pharm. Res. 2018; 8(3): 175-184.
22.    Gupta S.,Jain R., Kapur S. Statins: A Review of Wonder Drug from Fungus. Research J. Pharm. and Tech. 7(10): Oct. 2014 Page 1201-1207.
23.    Ashna A, Jeena S, Vidhya PV, Venkateswaramurthy. N, Sambathkumar. R. Statins: Pleiotropic Effect. Research J. Pharm. and Tech. 2016; 9(7):977-981.
24.    Banach M, Patti AM, Giglio RV, et al. The Role of Nutraceuticals in Statin Intolerant Patients. J Am Coll Cardiol. 2018;72(1):96-118. doi:10.1016/j.jacc.2018.04.040
25.    Chen KN, He L, Zhong LM, Ran YQ, Liu Y. Meta-Analysis of Dyslipidemia Management for the Prevention of Ischemic Stroke Recurrence in China. Front Neurol. 2020; 11:483570. Published 2020 Nov 19. doi:10.3389/fneur.2020.483570
26.    Hsu HY, Lin CJ, Lee YS, Wu TH, Chien KL. Efficacy of more intensive lipid-lowering therapy on cardiovascular diseases: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2020;20(1):334. Published 2020 Jul 13. doi:10.1186/s12872-020-01567-1
27.    Ingersgaard MV, Helms Andersen T, Norgaard O, Grabowski D, Olesen K. Reasons for Nonadherence to Statins - A Systematic Review of Reviews. Patient Prefer Adherence. 2020; 14:675-691. Published 2020 Apr 2. doi:10.2147/PPA.S245365
28.    Kee PS, Chin PKL, Kennedy MA, Maggo SDS. Pharmacogenetics of Statin-Induced Myotoxicity. Front Genet. 2020; 11:575678. Published 2020 Oct 16. doi:10.3389/fgene.2020.575678
29.    Crisan E, Patil VK. Neuromuscular Complications of Statin Therapy. Curr Neurol Neurosci Rep. 2020;20(10):47. Published 2020 Aug 25. doi:10.1007/s11910-020-01064-0
30.    Liu M, Fan F, Zhang Y, Li J. The association of GATM polymorphism with statin-induced myopathy: a systematic review and meta-analysis. Eur J Clin Pharmacol. 2021;77(3):349-357. doi:10.1007/s00228-020-03019-3
31.    Kim JB, Song WH, Park JS, et al. A randomized, open-label, parallel, multi-center Phase IV study to compare the efficacy and safety of atorvastatin 10 and 20 mg in high-risk Asian patients with hypercholesterolemia. PLoS One. 2021;16(1):e0245481. Published 2021 Jan 22. doi:10.1371/journal.pone.0245481
32.    Stein B, Ward T, Hale G, Lyver E. Safety of High-Intensity Statins in the Veteran Population: Atorvastatin 40 to 80 mg Compared With Rosuvastatin 20 to 40 mg. Ann Pharmacother. 2020;54(5):405-413. doi:10.1177/1060028019888487
33.    Rezende Macedo do Nascimento RC, Mueller T, Godman B, et al. Real-world evaluation of the impact of statin intensity on adherence and persistence to therapy: A Scottish population-based study. Br J Clin Pharmacol. 2020;86(12):2349-2361. doi:10.1111/bcp.14333
34.    Baggett MC, Nykamp D. Statin-Associated Bilateral Foot Myopathy. J Pharm Pract. 2020;33(6):899-902. doi:10.1177/0897190019857851
35.    Ferri N, Corsini A. Clinical Pharmacology of Statins: an Update. Curr Atheroscler Rep. 2020;22(7):26. Published 2020 Jun 3. doi:10.1007/s11883-020-00844-w
36.    Drexel H, Coats AJS, Spoletini I, et al. An expert opinion paper on statin adherence and implementation of new lipid-lowering medications by the ESC Working Group on Cardiovascular Pharmacotherapy: Barriers to be overcome [published correction appears in Eur Heart J Cardiovasc Pharmacother. 2020 Sep 1;6(5):291]. Eur Heart J Cardiovasc Pharmacother. 2020;6(2):115-121. doi:10.1093/ehjcvp/pvz079
37.    Tarn DM, Barrientos M, Pletcher MJ, et al. Perceptions of Patients with Primary Nonadherence to Statin Medications. J Am Board Fam Med. 2021;34(1):123-131. doi:10.3122/jabfm.2021.01.200262
38.    Shaito A, Thuan DTB, Phu HT, et al. Herbal Medicine for Cardiovascular Diseases: Efficacy, Mechanisms, and Safety. Front Pharmacol. 2020; 11:422. Published 2020 Apr 7. doi:10.3389/fphar.2020.00422
39.    Cicero AFG, Colletti A, Bajraktari G, et al. Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Arch Med Sci. 2017;13(5):965-1005. doi:10.5114/aoms.2017.69326
40.    Banach M, Patti AM, Giglio RV, et al. The Role of Nutraceuticals in Statin Intolerant Patients. J Am Coll Cardiol. 2018;72(1):96-118. doi:10.1016/j.jacc.2018.04.040
41.    Dludla PV, Silvestri S, Orlando P, et al. Exploring the Comparative Efficacy of Metformin and Resveratrol in the Management of Diabetes-associated Complications: A Systematic Review of Preclinical Studies. Nutrients. 2020;12(3):739. Published 2020 Mar 11. doi:10.3390/nu12030739
42.    Rahayu YYS, Araki T, Rosleine D. Factors affecting the use of herbal medicines in the universal health coverage system in Indonesia. J Ethnopharmacol. 2020; 260:112974. doi:10.1016/j.jep.2020.112974
43.    Baumgartner S, Bruckert E, Gallo A, Plat J. The position of functional foods and supplements with a serum LDL-C lowering effect in the spectrum ranging from universal to care-related CVD risk management. Atherosclerosis. 2020; 311:116-123. doi:10.1016/j.atherosclerosis.2020.07.019
44.    Gil-Ramírez A, Caz V, Smiderle FR, et al. Water-Soluble Compounds from Lentinula edodes Influencing the HMG-CoA Reductase Activity and the Expression of Genes Involved in the Cholesterol Metabolism. J Agric Food Chem. 2016;64(9):1910-1920. doi:10.1021/acs.jafc.5b05571
45.    Ding F, Ma B, Nazary-Vannani A, et al. The effects of green coffee bean extract supplementation on lipid profile in humans: A systematic review and meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2020;30(1):1-10. doi:10.1016/j.numecd.2019.10.002
46.    Serban MC, Sahebkar A, Dragan S, et al. A systematic review and meta-analysis of the impact of Spirulina supplementation on plasma lipid concentrations. Clin Nutr. 2016;35(4):842-851. doi:10.1016/j.clnu.2015.09.007
47.    Huang H, Liao D, Dong Y, Pu R. Effect of quercetin supplementation on plasma lipid profiles, blood pressure, and glucose levels: a systematic review and meta-analysis. Nutr Rev. 2020;78(8):615-626. doi:10.1093/nutrit/nuz071
48.    Khare A, Gaur S. Cholesterol-Lowering Effects of Lactobacillus Species. Curr Microbiol. 2020;77(4):638-644. doi:10.1007/s00284-020-01903-w
49.    Berthold HK, Schulte DM, Lapointe JF, Lemieux P, Krone W, Gouni-Berthold I. The whey fermentation product malleable protein matrix decreases triglyceride concentrations in subjects with hypercholesterolemia: a randomized placebo-controlled trial. J Dairy Sci. 2011;94(2):589-601. doi:10.3168/jds.2010-3115
50.    Gouni-Berthold I, Schulte DM, Krone W, et al. The whey fermentation product malleable protein matrix decreases TAG concentrations in patients with the metabolic syndrome: a randomised placebo-controlled trial. Br J Nutr. 2012;107(11):1694-1706. doi:10.1017/S0007114511004843
51.    Zhang JW, Tong X, Wan Z, Wang Y, Qin LQ, Szeto IM. Effect of whey protein on blood lipid profiles: a meta-analysis of randomized controlled trials. Eur J Clin Nutr. 2016;70(8):879-885. doi:10.1038/ejcn.2016.39
52.    Nordestgaard BG, Varbo A. Triglycerides and cardiovascular disease. Lancet. 2014;384(9943):626-635. doi:10.1016/S0140-6736(14)61177-6
53.    Borodin, E. A., Menshikova, I. G., Dorovskikh, V. A., Feoktistova, N. A., Shtarberg, M. A., Yamamoto, T., Takamatsu, K., Mori, H., and Yamamoto, S. (2009). Effects of two-month consumption of 30 g a day of soy protein isolate or skimmed curd protein on blood lipid concentration in Russian adults with hyperlipidemia. Journal of nutritional science and vitaminology, 55(6), 492–497. https://doi.org/10.3177/jnsv.55.492
54.    Ramdath DD, Padhi EM, Sarfaraz S, Renwick S, Duncan AM. Beyond the Cholesterol-Lowering Effect of Soy Protein: A Review of the Effects of Dietary Soy and Its Constituents on Risk Factors for Cardiovascular Disease. Nutrients. 2017;9(4):324. Published 2017 Mar 24. doi:10.3390/nu9040324
55.    Jung SJ, Kim WR, Oh MR, Cha YS, Park BH, Chae SW. A Randomized, Double-Blind, Placebo-Controlled Clinical Trial Assessing the Effects of Angelica Gigas Nakai Extract on Blood Triglycerides. Nutrients. 2020;12(2):377. Published 2020 Jan 31. doi:10.3390/nu12020377
56.    Youn JS, Ham YM, Yoon WJ, et al. Cynanchum wilfordii Etanolic Extract Controls Blood Cholesterol: A Double-blind, Randomized, Placebo-Controlled, Parallel Trial. Nutrients. 2019;11(4):836. Published 2019 Apr 12. doi:10.3390/nu11040836
57.    Jia W, Li Y, Wan J, et al. Effects of Xuezhitong in Patients with Hypertriglyceridemia: a Multicentre, Randomized, Double-Blind, Double Simulation, Positive Drug and Placebo Parallel Control Study. Cardiovasc Drugs Ther. 2020;34(4):525-534. doi:10.1007/s10557-020-06965-3
58.    Anderson RA, Zhan Z, Luo R, et al. Cinnamon extract lowers glucose, insulin and cholesterol in people with elevated serum glucose. J Tradit Complement Med. 2015;6(4):332-336. Published 2015 Apr 18. doi:10.1016/j.jtcme.2015.03.005
59.    Panahi Y, Pishgoo B, Beiraghdar F, Araghi ZM, Sahebkar A, Abolhasani E. Results of a randomized,open-label,clinical trial investigating the effects of supplementation with Heracleumpersicum extract as an adjunctive therapy for dyslipidemia. ScientificWorldJournal. 2011;11:592-601. Published 2011 Mar 7. doi:10.1100/tsw.2011.43
60.    Tariq S, Imran M, Mushtaq Z, Asghar N. Phytopreventive antihypercholesterolmic and antilipidemic perspectives of zedoary (Curcuma Zedoaria Roscoe.) herbal tea. Lipids Health Dis. 2016;15:39. Published 2016 Feb 27. doi:10.1186/s12944-016-0210-y
61.    Upadya H, Prabhu S, Prasad A, Subramanian D, Gupta S, Goel A. A randomized, double blind, placebo controlled, multicenter clinical trial to assess the efficacy and safety of Emblica officinalis extract in patients with dyslipidemia. BMC Complement Altern Med. 2019;19(1):27. Published 2019 Jan 22. doi:10.1186/s12906-019-2430-y
62.    Tenore GC, Caruso D, Buonomo G, et al. A Healthy Balance of Plasma Cholesterol by a Novel Annurca Apple-Based Nutraceutical Formulation: Results of a Randomized Trial. J Med Food. 2017;20(3):288-300. doi:10.1089/jmf.2016.0152
63.    Hajmohammadi Z, Heydari M, Nimrouzi M, et al. Rhus coriaria L. increases serum apolipoprotein-A1 and high-density lipoprotein cholesterol levels: a double-blind placebo-controlled randomized clinical trial. J Integr Med. 2018;16(1):45-50. doi:10.1016/j.joim.2017.12.007
64.    Arevström L, Bergh C, Landberg R, et al. Freeze-dried bilberry (Vaccinium myrtillus) dietary supplement improves walking distance and lipids after myocardial infarction: an open-label randomized clinical trial. Nutr Res. 2019; 62:13-22. doi:10.1016/j.nutres.2018.11.008
65.    Kuriyan R, Kumar DR, R R, Kurpad AV. An evaluation of the hypolipidemic effect of an extract of Hibiscus Sabdariffa leaves in hyperlipidemic Indians: a double blind, placebo controlled trial. BMC Complement Altern Med. 2010; 10:27. Published 2010 Jun 17. doi:10.1186/1472-6882-10-27
66.    Pelegrin S, Galtier F, Chalançon A, et al. Effects of Nigella sativa seeds (black cumin) on insulin secretion and lipid profile: A pilot study in healthy volunteers. Br J Clin Pharmacol. 2019;85(7):1607-1611. doi:10.1111/bcp.13922
67.    Verhoeven V, Van der Auwera A, Van Gaal L, et al. Can red yeast rice and olive extract improve lipid profile and cardiovascular risk in metabolic syndrome?: A double blind, placebo controlled randomized trial. BMC Complement Altern Med. 2015; 15:52. Published 2015 Mar 10. doi:10.1186/s12906-015-0576-9
68.    Derosa G, D'Angelo A, Romano D, Maffioli P. Effects of a Combination of Berberis aristata, Silybum marianum and Monacolin on Lipid Profile in Subjects at Low Cardiovascular Risk; A Double-Blind, Randomized, Placebo-Controlled Trial. Int J Mol Sci. 2017;18(2):343. Published 2017 Feb 7. doi:10.3390/ijms18020343
69.    Trimarco V, Izzo R, Stabile E, et al. Effects of a new combination of nutraceuticals with Morus alba on lipid profile, insulin sensitivity and endotelial function in dyslipidemic subjects. A cross-over, randomized, double-blind trial. High Blood Press Cardiovasc Prev. 2015;22(2):149-154. doi:10.1007/s40292-015-0087-2
70.    EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS), Younes M, Aggett P, et al. Scientific opinion on the safety of monacolins in red yeast rice. EFSA J. 2018;16(8):e05368. Published 2018 Aug 3. doi:10.2903/j.efsa.2018.5368
71.    Maki KC, Lawless AL, Reeves MS, et al. Lipid effects of a dietary supplement softgel capsule containing plant sterols/stanols in primary hypercholesterolemia. Nutrition. 2013;29(1):96-100. doi:10.1016/j.nut.2012.05.002
72.    Bays HE, Evans JL, Maki KC, et al. Chitin-glucan fiber effects on oxidized low-density lipoprotein: a randomized controlled trial. Eur J Clin Nutr. 2013;67(1):2-7. doi:10.1038/ejcn.2012.121
73.    Choi IH, Noh JS, Han JS, Kim HJ, Han ES, Song YO. Kimchi, a fermented vegetable, improves serum lipid profiles in healthy young adults: randomized clinical trial. J Med Food. 2013;16(3):223-229. doi:10.1089/jmf.2012.2563

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