Beyond blood lipids: phytosterols, statins and omega-3 polyunsaturated fatty acid therapy for hyperlipidemia

J Nutr Biochem. 2009 Dec;20(12):927-39. doi: 10.1016/j.jnutbio.2009.06.009. Epub 2009 Sep 3.

Abstract

Phytosterols and omega-3 fatty acids are natural compounds with potential cardiovascular benefits. Phytosterols inhibit cholesterol absorption, thereby reducing total- and LDL cholesterol. A number of clinical trials have established that the consumption of 1.5-2.0 g/day of phytosterols can result in a 10-15% reduction in LDL cholesterol in as short as a 3-week period in hyperlipidemic populations. Added benefits of phytosterol consumption have been demonstrated in people who are already on lipid-lowering medications (statin drugs). On the other hand, omega-3 fatty acid supplementation has been associated with significant hypotriglyceridemic effects with concurrent modifications of other risk factors associated with cardiovascular disease, including platelet function and pro-inflammatory mediators. Recent studies have provided evidence that the combination of phytosterols and omega-3 fatty acids may reduce cardiovascular risk in a complementary and synergistic way. This article reviews the health benefits of phytosterols and omega-3 fatty acids, alone or in combination with statins, for the treatment/management of hyperlipidemia, with particular emphasis on the mechanisms involved.

Publication types

  • Review

MeSH terms

  • Anticholesteremic Agents / therapeutic use
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / etiology
  • Cholesterol, LDL / drug effects
  • Diet
  • Eicosanoids / biosynthesis
  • Fatty Acids, Omega-3 / therapeutic use*
  • Food, Fortified
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hyperlipidemias / drug therapy*
  • Intestinal Absorption
  • Lipids / blood
  • Micelles
  • Phytosterols / therapeutic use*
  • Risk Factors

Substances

  • Anticholesteremic Agents
  • Cholesterol, LDL
  • Eicosanoids
  • Fatty Acids, Omega-3
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipids
  • Micelles
  • Phytosterols