Chinese herbal medicines for hypercholesterolemia

Liu, Zhao Lan; Liu, Jianping; Zhang, Anthony Lin; Wu, Qiong; Ruan, Yuhua; Lewith, George; Visconte, D

doi:10.1002/14651858.cd008305.pub2

Cited by 29 publications

(13 citation statements)

References 48 publications

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“…The lipid modification effects appeared to be similar to pravastatin, simvastatin, atorvastatin, lovastatin, or fluvastatin [ 40 ]. A latest systematic review also indicated the beneficial effects of Xuezhikang in the treatment of hyperlipidemia [ 2 ]. The lipid-regulating effects of Xuezhikang in these reviews were similar to our findings.…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review of Xuezhikang, an Extract from Red Yeast Rice, for Coronary Heart Disease Complicated by Dyslipidemia

Shang

Liu

Chen

et al. 2012

Evidence-Based Complementary and Alternative Medicine

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Objective. This systematic review aims to evaluate the benefit and side effect of Xuezhikang for coronary heart disease (CHD) complicated by dyslipidemia. Methods. All randomized clinical trials (RCTs) with Xuezhikang as a treatment for CHD combined with dyslipidemia were considered for inclusion. Data extraction and analyses and quality assessment were conducted according to the Cochrane standards. Results. We included 22 randomized trials. Xuezhikang showed significant benefit on the incidence of all-cause deaths, CHD deaths, myocardial infarction, and revascularization as compared with placebo based on conventional treatment for CHD. It remarkably lowered total cholesterol (TC), triglyceride (TG), and low-density lipoprotein-cholesterol (LDL-C) as compared with the placebo or inositol nicotinate group, which was similar to statins group. Xuezhikang also raised high-density lipoprotein cholesterol (HDL-C) compared to placebo or no intervention, which was similar to Inositol nicotinate and slightly inferior to statins. The incidence of adverse events did not differ between the Xuezhikang and control group. Conclusions. Xuezhikang showed a comprehensive lipid-regulating effect and was safe and effective in reducing cardiovascular events in CHD patients complicated by dyslipidemia. However, more rigorous trials with high quality are needed to give high level of evidence.

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Section: Discussionmentioning

confidence: 99%

“…The health enhancing qualities of this yeast have been introduced and used in China for over two thousand years. At latest systematic review indicated the beneficial effects of Xuezhikang in the treatment of hyperlipidemia [ 2 ]. Therefore, Xuezhikang has been recommended in a guideline for China adult dyslipidemia prevention [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of Xuezhikang, an Extract from Red Yeast Rice, for Coronary Heart Disease Complicated by Dyslipidemia

Shang

Liu

Chen

et al. 2012

Evidence-Based Complementary and Alternative Medicine

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“…At the present time, with regarding to the mechanism by which ezetimibe plus Xuezhikang causes an attenuated increase in PCSK9 levels compared to monotherapy and co-therapy with ezetimibe plus pitavastatin is unclear, but it may likely associated with the chemical constituents of Xuezhikang. Xuezhikang, a Chinese traditional medicine, is widely used as a lipid-lowering drug, and its main components contain lovastatin, as well as other useful substances [ 16 - 18 ]. Recent studies including our data have shown that Xuezhikang has many pleiotropic effects, which could effectively modify not only lipid profile but also inflammatory markers [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Xuezhikang, a partially purified extract of fermented red yeast rice, contains 13 kinds of natural statins (high amounts of lovastatin), unsaturated fatty acids, ergosterol, flavonoids, and some other components [ 16 , 17 ]. A systematic review demonstrated that Xuezhikang exerted significant lipid-lowering effects in the treatment of hyperlipidemia [ 18 ]. Recently, clinical studies indicated that Xuezhikang could be used as an alternative therapy for patients intolerant of statin [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of currently prescribed lipid-lowering drugs on plasma PCSK9 concentration: single or in combination study in rats

Zhang

et al. 2014

Lipids Health Dis

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BackgroundAn emerging data suggested a significant impact of statins on PCSK9 concentration, while the rapid impacts of other lipid-lowering drugs such as ezetimibe and xuezhikang alone or in combination on PCSK9 and lipid profile have not been assessed. This study aims to investigate whether an enhanced PCSK9 concentration by single or combined therapy of lipid-lowering drugs currently used precedes the changes of lipid profile in rats.MethodsSixty-three rats were randomly divided into six groups and orally administrated with placebo (N = 13), ezetimibe 10 mg/kg daily, Xuezhikang 1200 mg/kg daily, ezetimibe 10 mg/kg plus Xuezhikang 1200 mg/kg daily, pitavastatin 10 mg/kg daily or pitavastatin 10 mg/kg plus ezetimibe 10 mg/kg daily for 3 days (N = 10 for each group respectively). Blood samples were obtained at day 3 after orally administration. Plasma PCSK9 levels were determined by ELISA and lipid profile were measured by enzymatic assay.ResultsEzetimibe, Xuezhikang and pitavastatin alone and Xuezhikang plus ezetimibe as well as pitavastatin plus ezetimibe increased PCSK9 levels by 124%, 56%, 111%, 63% and 204% respectively (p < 0.05 compared with placebo). However, Xuezhikang plus ezetimibe did not enhance greater PCSK9 levels compared to monotherapy. Ezetimibe and pitavastatin in combination induced higher PCSK9 levels than pitavastatin monotherapy or co-therapy with ezetimibe plus Xuezhikang. There was no significant difference between any groups with regard to lipid profile levels at day 3 (P > 0.05).ConclusionsElevated PCSK9 concentration by ezetimibe, Xuezhikang and pitavastatin alone or in combination was found prior to the alterations of lipid profile in rats. Combination of Xuezhikang and ezetimibe significantly attenuated increase in PCSK9 compared to ezetimibe plus pitavastatin, suggesting that the former combination may be better than the latter in future clinical application.

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“…Xuezhikang, an extract of red yeast rice, has been widely used in traditional Chinese medicine as a functional food to treat patients with cardiovascular disease for more than two thousand years. Today, Xuezhikang is recommended for the treatment of dyslipidemia [22,23] . Clinical benefits of Xuezhikang use have also been documented in coronary heart disease (CHD) patients who received medication combined with Xuezhikang to treat dyslipidemia in randomized controlled trials [24,25] .…”

Section: Introductionmentioning

confidence: 99%

Isoflavones and phytosterols contained in Xuezhikang capsules modulate cholesterol homeostasis in high-fat diet mice

Dong

Sun

et al. 2015

Acta Pharmacol Sin

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Aim: Xuezhikang (XZK), an extract of red yeast rice, has been widely used in traditional Chinese medicine to treat cardiovascular disease. Three fractions F1, F2 and F3 (primarily containing isoflavones, monacolins or phytosterols, respectively) are extracted from Xuezhikang capsules. In this study we evaluated the lipid-lowering effects of these fractions and explored the potential mechanisms of actions. Methods: Mice treated with a high-fat diet (HFD) were orally administered lovastatin (10 mg·kg -1 ·d -1 ), XZK (1200 mg·kg -1 ·d -1 ), F1 (27.5 mg·kg -1 ·d -1 ), F2 (11.3 mg·kg -1 ·d -1 ) or F3 (35 mg·kg -1 ·d -1 ) for 10 weeks. Lipids were measured using commercial enzymatic kits, and the mRNA and protein levels of genes involved in cholesterol and bile acid homeostasis were evaluated using qRT-PCR and Western blot analysis, respectively. Results: XZK increased the fecal excretion of lipids and bile acids, reduced serum TC, TG and LDL-C levels by 40%, 55% and 46%, respectively, and increased serum HDL-C by 31%. Administration of F1 repressed serum TC and TG by 24% and 52%, respectively, and elevated hepatic synthesis of CYP7A1. It also increased hepatic elimination of bile acids in the fecal excretions by 79% through upregulating BSEP and downregulating NTCP. Administration of F3 decreased serum TC, TG and LDL-C levels by 33%, 29% and 39%, respectively, and increased serum HDL-C by 28%, significantly reduced intestinal absorption of cholesterol by inhibiting the transcription of NPC1L1, and elevated excretion of TC, FC and CE by 96%, 72% and 101%, respectively. Administration of F2 showed pharmacological effects similar to those of lovastatin. Conclusion: Isoflavones and phytosterols in XZK exert cholesterol-lowering effects in HFD mice through mechanisms that differ from those of lovastatin. Isoflavones and phytosterols act in a complimentary manner: through enhancing the elimination of bile acids and reducing intestinal cholesterol absorption, respectively.

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Chinese herbal medicines for hypercholesterolemia

Cited by 29 publications

References 48 publications

A Systematic Review of Xuezhikang, an Extract from Red Yeast Rice, for Coronary Heart Disease Complicated by Dyslipidemia

A Systematic Review of Xuezhikang, an Extract from Red Yeast Rice, for Coronary Heart Disease Complicated by Dyslipidemia

Impact of currently prescribed lipid-lowering drugs on plasma PCSK9 concentration: single or in combination study in rats

Isoflavones and phytosterols contained in Xuezhikang capsules modulate cholesterol homeostasis in high-fat diet mice

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