Penson, P and Banach, M (2020) The role of nutraceuticals in the optimization of lipid-lowering therapy in high-risk patients with dyslipidemia. Current Atherosclerosis Reports, 22. ISSN 1523-3804

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Abstract

Purpose of review: We aimed to summarise recent guidelines, position papers and high-quality clinical research relating the use of nutraceuticals in the management of individuals at high risk of atherosclerotic cardiovascular disease. Recent findings: It is essential that individuals at high risk of cardiovascular disease receive guideline-directed evidence-based therapies to reduce their risk of morbidity and mortality from cardiovascular events. Compared with conventional therapeutics, nutraceuticals have undergone relatively little investigation in randomised controlled trials. Thus, recommendations for nutraceuticals in international guidelines are rare, and nutraceuticals should not be used preferentially in place of statins. Nevertheless, recent position papers from the International Lipid Expert Panel, and clinical evidence from studies of triglyceride reduction by polyunsaturated fatty acid administration demonstrate that nutraceuticals do have an important role in optimising therapy in individuals at high risk of cardiovascular disease. Roles for nutraceuticals include: 1) Managing residual risk associated with lipids other than low-density lipoprotein cholesterol (LDL-C); 2) Managing non-lipid-mediated residual risk; 3) Optimizing LDL-C treatment in statin intolerance. 4) Optimizing LCL-C treatment when add-on therapies for statins are not available; 5) As adjuncts to lifestyle for individuals at high lifetime risk of atherosclerotic cardiovascular disease (ASCVD). The strength of evidence for each of these applications is variable. Summary In addition to guideline-directed therapeutics, nutraceuticals may have roles in optimizing preventative therapy and targeting residual risk in individuals at high-risk of ASCVD. Application of Good Manufacturing Practice and randomised-controlled trials when producing and evaluating nutraceuticals will expand the armoury of evidence-based agents for the prevention of ASCVD.

Item Type:	Article
Uncontrolled Keywords:	1102 Cardiorespiratory Medicine and Haematology
Subjects:	R Medicine > RM Therapeutics. Pharmacology
Divisions:	Pharmacy & Biomolecular Sciences
Publisher:	Springer (part of Springer Nature)
Date Deposited:	19 Aug 2020 08:47
Last Modified:	11 Jan 2022 16:45
URI:	https://researchonline.ljmu.ac.uk/id/eprint/13513

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