Red yeast rice lowers cholesterol in physicians - a double blind, placebo controlled randomized trial Long-Term Effects of Xuezhikang on Blood Pressure in Hypertensive Patients with Previous Myocardial Infarction: Data from the Chinese Coronary Secondary Prevention Study (CCSPS) Tolerability of red yeast rice (2,400 mg twice daily) versus pravastatin (20 mg twice daily) in patients with previous statin intolerance. Relationship between Adiponectin and Leptin, and Blood Lipids in Hyperlipidemia Patients Treated with Red Yeast Rice Effect of Red Yeast Rice and Coconut, Rice Bran or Sunflower Oil Combination in Rats on Hypercholesterolemic Diet. Hypotensive effect of atorvastatin is not related to changes in inflammation and oxidative stress. Improvement of hypertension, endothelial function and systemic inflammation following short-term supplementation with red beet (Beta vulgaris L.) juice: a randomized crossover pilot study Clinical evidence of efficacy of red yeast rice and berberine in a large controlled study versus diet Short-Term Effects of a Combined Nutraceutical on Lipid Level, Fatty Liver Biomarkers, Hemodynamic Parameters, and Estimated Cardiovascular Disease Risk: A Double-Blind, Placebo-Controlled Randomized Clinical Trial Dietary Flavonoids Added to Pharmacological Antihypertensive Therapy are Effective in Improving Blood Pressure Kiwifruit consumption favourably affects plasma lipids in a randomised controlled trial in hypercholesterolaemic men. Usefulness of Nutraceuticals (Armolipid Plus) Versus Ezetimibe and Combination in Statin-Intolerant Patients With Dyslipidemia With Coronary Heart Disease. Daily consumption of red grape cell powder in a dietary dose improves cardiovascular parameters: a double blind, placebo-controlled, randomized study NUtraceutical TReatment for hYpercholesterolemia in HIV-infected patients: The NU-TRY(HIV) randomized cross-over trial. Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Statin therapy, lipid levels, C-reactive protein and the survival of patients with angiographically severe coronary artery disease. A pilot, randomized controlled trial to examine the health outcomes of raisin consumption in patients with diabetes. Effect of red yeast rice combined with antioxidants on lipid pattern, hs-CRP level, and endothelial function in moderately hypercholesterolemic subjects Effect of conjugated linoleic acid, vitamin E and their combination on lipid profiles and blood pressure of Iranian adults with active rheumatoid arthritis Efficacy and Tolerability of a Nutraceutical Combination (Red Yeast Rice, Policosanols, and Berberine) in Patients with Low-Moderate Risk Hypercholesterolemia: A Double-Blind, Placebo-Controlled Study Association between different lipid-lowering treatment strategies and blood pressure control in the Brisighella Heart Study. Impact of Vitamin E Supplementation on Blood Pressure and Hs-CRP in Type 2 Diabetic Patients | doi: 10.5681/hpp.2012.009. Beneficial impact of Xuezhikang on cardiovascular events and mortality in elderly hypertensive patients with previous myocardial infarction from the China Coronary Secondary Prevention Study (CCSPS).
Background In recent years , red yeast rice ( RYR ) supplements have been marketed aggressively as a natural way to lower cholesterol ; however , the large majority of commercially available products have not been studied according to current research st and ards . Methods In a double blind placebo controlled r and omized trial , 52 physicians and their spouses with a total cholesterol level of > 200 mg/dL were r and omly allocated to receive a RYR extract or placebo for 8 weeks . As a primary outcome measure , we compared the before-after difference in lipid levels between both groups . As secondary outcome measures we looked at side-effects , CK elevation and a change in cardiovascular risk . Results LDL ( low density lipoprotein ) cholesterol was lowered with 36 mg/dL ( 22 % ) and total cholesterol with 37 mg/dL ( 15 % ) in the intervention group . This result was statistically significant as compared to the control group , in which no reduction in total cholesterol and LDL was observed ( p < 0.001 ) . There was no marked difference in CK ( creatine kinase)-elevation or reported side-effects between study groups . In 5/31 participants in the intervention group , the lipid lowering effect result ed in lower cardiovascular risk as measured with SCORE ( Systematic COronary Risk Evaluation ) . Conclusions The RYR formulation under study was effective in lowering cholesterol and LDL cholesterol in this study population . RYR therapy may be an attractive and relatively well studied alternative in patients who are intolerant for statins or who have objections against pharmacological lipid lowering . However , consumers need to be warned that the actual content of commercially available preparations is not assured by governmental regulations , which raises effectiveness and safety issues . Trial registration Clinical trials.gov , nr : Several previous trials from Western population studies have showed that statins may help reduce blood pressure ( BP ) . However , r and omized clinical data is limited . Xuezhikang , a partially extract of red yeast rice , contains a family of naturally occurring statins , and has a marked impact on lipids , but it is unknown whether Xuezhikang has any effect on BP during long-term follow-up in the Chinese population . This is a post-hoc subgroup analysis of a r and omized , double-blinded , placebo-controlled , parallel group clinical trial , Chinese Coronary Secondary Prevention Study ( CCSPS ) . A total of 2704 hypertensive patients with previous myocardial infa rct ion ( MI ) were assigned either to placebo ( n = = 1341 ) or to Xuezhikang ( n = = 1363 ) daily for an average of 4.5 years . The primary outcome was the unadjusted changes in mean arterial pressure ( MAP ) from baseline to 6 months . We also assessed systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) , and pulse pressure . Analysis of covariance was used to calculate the adjusted effects of treatment on changes in these outcomes at 6 , 12 , 24 , and 48 months post-r and om- ization , after controlling for potential confounders . This analysis included 2704//4870 ( 55.5%% ) hypertensive patients for whom BP was measured at baseline and at least one follow-up visit after r and omization . Median duration of the follow-up was 4.5 years ( 54 months ) , and 25 patients ( 0.92%% ) were lost to the last follow-up because of adverse effects . The results showed that the unadjusted and adjusted changes in MAP , SBP , DBP , or pulse pressure from baseline were not significantly different for Xuezhikang or placebo recipients at 6 , 12 , 24 , and 48 months after r and omization . In this post-hoc subgroup analysis , we failed to demonstrate any significant reducing effects of Xuezhikang on BP in Chinese hypertensive patients with previous MI , suggesting that further prospect i ve study on the effects of statins on BP would be needed , especially in high-risk patients Currently , no consensus has been reached regarding the management of hyperlipidemia in patients who develop statin-associated myalgia ( SAM ) . Many statin-intolerant patients use alternative lipid-lowering therapies , including red yeast rice . The present trial evaluated the tolerability of red yeast rice versus pravastatin in patients unable to tolerate other statins because of myalgia . The study was conducted in a community-based setting in Philadelphia , Pennsylvania . A total of 43 adults with dyslipidemia and a history of statin discontinuation because of myalgia were r and omly assigned to red yeast rice 2,400 mg twice daily or pravastatin 20 mg twice daily for 12 weeks . All subjects were concomitantly enrolled in a 12-week therapeutic lifestyle change program . The primary outcomes included the incidence of treatment discontinuation because of myalgia and a daily pain severity score . The secondary outcomes were muscle strength and plasma lipids . The incidence of withdrawal from medication owing to myalgia was 5 % ( 1 of 21 ) in the red yeast rice group and 9 % ( 2 of 22 ) in the pravastatin group ( p = 0.99 ) . The mean pain severity did not differ significantly between the 2 groups . No difference was found in muscle strength between the 2 groups at week 4 ( p = 0.61 ) , week 8 ( p = 0.81 ) , or week 12 ( p = 0.82 ) . The low-density lipoprotein cholesterol level decreased 30 % in the red yeast rice group and 27 % in the pravastatin group . In conclusion , red yeast rice was tolerated as well as pravastatin and achieved a comparable reduction of low-density lipoprotein cholesterol in a population previously intolerant to statins Background : This study aim ed to investigate the possible relationships between adiponectin and leptin , blood lipids such as total cholesterol , high-density lipoprotein cholesterol ( HDL-C ) , low-density lipoprotein cholesterol ( LDL-C ) , and triglycerides ( TG ) as well as other clinical biomarkers in hyperlipidemia patients treated with red yeast rice .  Methods : 30 patients with primary hyperlipidemia were recruited , treated with red rice yeast capsules 600 mg twice a day for 8 weeks , and followed up for 4 weeks . The primary endpoint was the mean difference in LDL-C from baseline to week 8 , while the secondary endpoints were the mean percentage changes from baseline of total cholesterol , TG , HDL-C , adiponectin , and leptin . Results : At week 8 , the decrease in LDL-C and total cholesterol was -38.11 ± 30.90 mg/dl ( p < 0.0001 ) and -44.54 ± 27.46 mg/dl ( p < 0.0001 ) , respectively , and the increase in adiponectin was 35.83 ± 67.85 μg/ml ( p = 0.017 ) as compared to baseline . Adiponectin also correlated positively with HDL-C ( r2 = 0.39 ; p = 0.001 ) . Serum leptin correlated negatively with TG ( r2 = 0.19 ; p = 0.035 ) , and there was a trend of correlation between leptin and HDL-C , but this was not statistically significant ( r2 = 0.16 ; p = 0.052 ) . Conclusion : Red yeast rice can significantly increase adiponectin and can significantly lower LDL-C and total cholesterol levels . Adiponectin correlates positively with HDL-C while serum leptin correlates negatively with TG  . Red yeast rice has a potentially protective effect in obesity-related and cardiovascular diseases INTRODUCTION Dietary supplements provide a novel population based health approach for treating hyperlipidemias . Red yeast rice is known to have lipid lowering effects . Combination of red yeast rice with various oils is taken by different population around the world . AIM In this present work , we aim ed to compare the effects of red yeast rice with different oil ( coconut , rice bran and sunflower oil ) supplementations on lipid levels and oxidative stress in rats fed on hypercholesterolemic diet . MATERIAL S AND METHODS A R and omized controlled study was conducted on 28 male Sprague Dawley rats . It included 4 arms-Control arm ( hypercholesterolemic diet ) , Test arm A ( hypercholesterolemic diet + Red yeast rice + Rice bran oil ) , arm B ( hypercholesterolemic diet + Red yeast rice + Coconut oil ) and arm C ( hypercholesterolemic diet + Red yeast rice + Sunflower oil ) . At the end of one month , serum cholesterol , triglycerides , MDA and paraoxonase was measured . The mean values of analytes between the different groups were compared using student ' t- ' test . RESULTS The rats fed with red yeast rice and rice bran oil combination showed significantly lower levels of serum cholesterol , triglycerides and MDA when compared to the controls . The serum paraoxonase levels were significantly higher in this group when compared to the controls . The rats fed with red yeast rice and coconut oil combination showed significantly lower serum cholesterol and MDA levels when compared to the controls . The mean triglyceride and paraoxonase levels did not show any statistically significant difference from the controls . The rats on red yeast rice and sunflower oil combination did not show any statistically significant difference in the lipid levels and oxidative stress parameters . CONCLUSION The food combination which had best outcome in preventing the development of hyperlipidemia and oxidative stress in rats fed with hypercholesterolemic diet was red yeast rice and rice bran oil . Combining red yeast rice with coconut oil and sunflower oil gave suboptimal benefits We sought to determine if atorvastatin lowers blood pressure in patients with previously diagnosed and well-controlled essential arterial hypertension and if this effect could be related to anti-inflammatory and anti-oxidative effects . Among 92 patients with essential arterial hypertension , we studied 56 non-smoking and normolipemic : 39 were r and omized to receive 80 mg atorvastatin daily for 3 months ( statin-treated patients , ST ) , and the rest continued a previous hypotensive therapy ( statin-free patients , SF ) . Blood pressure was measured using a 24-h ambulatory blood pressure measurement device . Serum levels of high-sensitivity C-reactive protein ( hs-CRP ) , total antioxidant status ( TAS ) and plasma peroxides ( assessed by Oxystat ) were measured in both groups . The mean change in systolic BP ( SBP ) for atorvastatin was -5.7 mmHg ( 95 % confidence interval CI , -4.1 to -7.2 mmHg ) , and the mean change in diastolic BP ( DBP ) was -3.9 mmHg ( 95 % CI , -2.7 to -5.0 mmHg ) . No change in BP in SF patients was observed . In the ST group , hs-CRP and peroxides did not significantly decrease . In the SF group , concentrations of hs-CRP proceeded to decrease while peroxides increased . In the ST group , changes in hs-CRP correlated with changes in total cholesterol and low-density lipoprotein cholesterol ( r = 0.41 , p = 0.013 and r = 0.35 , p = 0.04 , respectively ) but did not correlate with changes in BP . The hypotensive statin effect was independent of the hypolipemic effect . During three months of observation , TAS concentrations in both groups remained stable . In this r and omized study , additionally administered atorvastatin to non-smoking and normolipemic patients with well-controlled essential arterial hypertension result ed in reduction of BP . This effect was not followed by significant changes in hs-CRP , TAS or Oxystat concentrations . The hypotensive effect of atorvastatin did not depend on anti-inflammatory , anti-oxidative or hypolipemic actions Hypertension is a major risk factor for cardiovascular disease and has a prevalence of about one billion people worldwide . It has been shown that adherence to a diet rich in fruits and vegetables helps in decreasing blood pressure ( BP ) . This study aim ed to investigate the effect of raw beet juice ( RBJ ) and cooked beet ( CB ) on BP of hypertensive subjects . In this r and omized crossover study , 24 hypertensive subjects aged 25–68 years old were divided into two groups . One group took RBJ for 2 weeks and the other group took CB . After 2 weeks of treatment , both groups had a washout for 2 weeks then switched to the alternate treatment . Each participant consumed 250 ml day−1 of RBJ or 250 g day−1 of CB each for a period of 2 weeks . Body weight , BP , flow-mediated dilation ( FMD ) , lipid profile and inflammatory parameters were measured at baseline and after each period . According to the results , high-sensitivity C-reactive protein ( hs-CRP ) and tumour necrosis factor alpha ( TNF-α ) were significantly lower and FMD was significantly higher after treatment with RBJ compared with CB  ( P<0.05 ) . FMD was significantly ( P<0.05 ) increased , but systolic and diastolic BP , intracellular adhesion molecule-1 ( ICAM-1 ) , vascular endothelial adhesion molecule-1 ( VCAM-1 ) , hs-CRP , interleukin-6 , E-selectin and TNF-α were significantly ( P<0.05 ) decreased with RBJ or  CB . Total antioxidant capacity was increased and non-high-density lipoprotein ( HDL ) , low-density lipoprotein ( LDL ) and total cholesterol ( TC ) were decreased with RBJ but not with CB . Although both forms of beetroot were effective in improving BP , endothelial function and systemic inflammation , the raw beetroot juice had greater antihypertensive effects . Also more improvement was observed in endothelial function and systemic inflammation  with RBJ compared with CB Efficacy of a new patented proprietary combination of natural nutraceuticals ( PN ) containing natural hypolipidemic as red yeast , policosanol and berberine was tested in a large study on dyslipidemic patients in clinical practice . A parallel , controlled , r and omized , multicenter study was design ed . After 2 weeks on a stable dietary regimen , the patients were r and omized to PN 1 tablet/day associated with diet ( PN + D ) or diet alone ( D ) for 16 weeks . Entry criteria were : Tot-Chol > 200 mg/dL or LDL-Chol > 150 mg/dL without a clear indication for statins , or plasma triglycerides > 150 mg/dL.  Lipid pattern and CV parameters were evaluated at baseline and monthly . 1,751 patients were enrolled in 248 Italian units , 933 patients on PN + D and 818 on D. The baseline lipid values were : Tot-Chol 255.4 versus 243.1 mg/dL , LDL-Chol 170.1 versus 162.2 mg/dL , HDL-Chol 50.0 versus 48.8 mg/dL , and TG 190.5 versus 184.4 mg/dL. PN constantly and significantly improved lipid parameters versus D group : at 16 weeks −19.1 versus −9.4 % for Tot-Chol ( p < 0.001 ) , −23.5 versus −10.8 % for LDL-Chol ( p < 0.001 ) , + 11.6 versus + 4.0 % for HDL-Chol ( p < 0.001 ) , −17.9 versus −11.3 % for TG ( p < 0.001 ) . In conclusions , PN plus diet allows an effective improvement of blood lipids with a significant reduction of global CV risk , suggesting a role for PN in CHD prevention Introduction There is a growing interest in nutraceuticals improving cardiovascular risk factor levels and related organ damage . Methods This double-blind , placebo-controlled r and omized clinical trial aims to compare the effect of a combined nutraceutical containing red yeast rice ( 10 mg ) , phytosterols ( 800 mg ) , and l-tyrosol ( 5 mg ) on lipid profile , blood pressure , endothelial function , and arterial stiffness in a group of 60 patients with polygenic hypercholesterolemia resistant to Mediterranean diet . Results After 8 weeks of treatment , when compared to the placebo group , the active treated patients experienced a more favorable percentage change in total cholesterol ( −16.3 % vs 9.9 % , P < 0.001 always ) , LDL-C ( −23.4 % vs −13.2 % , P < 0.001 always ) , and hepatic steatosis index ( −2.8 % , P < 0.01 vs −1.8 % , P < 0.05 ) . Moreover , ALT ( −27.7 % , P < 0.001 ) , AST ( −13.8 % , P = 0.004 ) , and serum uric acid ( −12.3 % , P = 0.005 ) were reduced by the tested nutraceutical compound both compared to r and omization and to placebo , which did not affect these parameters ( P < 0.01 for all ) . Regarding the hemodynamic parameters , there was a decrease of systolic blood pressure ( −5.6 % ) with the active treatment not observed with placebo ( P < 0.05 vs baseline and placebo ) and endothelial reactivity improved , too ( −13.2 % , P < 0.001 vs baseline ) . Consequently , the estimated 10-year cardiovascular risk score improved by 1.19 % ( SE 0.4 % ) ( P = 0.01 ) in the nutraceutical-treated patients . Conclusion The tested nutraceutical association is able to improve the positive effects of a Mediterranean diet on a large number of CV risk factors and consequently of the estimated CV risk . Trial registration Clinical Trials.gov identifier NCT02492464 . Funding IBSA Farmaceutici Epidemiological studies have suggested that the daily intake of flavonoids is associated with a decreased risk of developing cardiovascular disease . Our purpose was to evaluate the effect of the addition of dietary flavonoids ( DF ) to antihypertensive treatment ( AHT ) , based on telmisartan ( Tms ) or captopril ( Cpr ) , on blood pressure ( BP ) , body mass index ( BMI ) , waist/hip ratio , leptin , lipid profile and inflammation in hypertensive young patients . An open‐label , r and omized , controlled trial was performed among 79 patients aged 20–55 years with grade I or grade II systemic arterial hypertension . The subjects were assigned to one of four groups for AHT plus DF during 6 months : Cpr ( n = 14 ) , Cpr + DF ( n = 19 ) , Tms ( n = 25 ) and Tms + DF ( n = 21 ) . DF consisted of dark chocolate , dehydrated red apple and green tea in an infusion to obtain a daily dose of 425.8 ± 13.9 mg epicatechin equivalents . The BP and anthropometric parameters were measured every 2 weeks . Lipid profile , leptin and hsCRP were determined by st and ard methods . The combination AHT‐DF produced an additional and significant reduction in ( i ) SBP/DBP of −5/−4 mmHg , being −7/−5 for Cpr + DF and −4/−3 for Tms + DF ; ( ii ) triglyceride levels ( −30.6 % ) versus AHT alone ( −9.6 % ) ; and ( iii ) leptin : Cpr + DF versus Tms + DF ( p < 0.005 ) . Finally , C‐reactive protein plasma levels were reduced significantly in all groups independently of the applied treatment . We conclude that the addition of flavonoids to pharmacological antihypertensive therapy shows additional benefits on BP , lipid profile , leptin , obesity and inflammation The unique composition of green kiwifruit has the potential to benefit CVD risk . The aim of the present study was to investigate the effect of consuming two green kiwifruits daily in conjunction with a healthy diet on plasma lipids and other metabolic markers and to examine response according to APOE genotype in hypercholesterolaemic men . After undergoing a 4-week healthy diet , eighty-five hypercholesterolaemic men ( LDL-cholesterol ( LDL-C ) > 3.0 mmol/l and TAG < 3 mmol/l ) completed an 8-week r and omised controlled cross-over study of two 4-week intervention sequences of two green kiwifruits per d plus healthy diet ( intervention ) or healthy diet alone ( control ) .  Anthropometric measures , blood pressure ( BP ) and fasting blood sample s ( plasma lipids , serum apoA1 and apoB , insulin , glucose , high-sensitivity C-reactive protein ( hs-CRP ) ) were taken at baseline , and at 4 and 8 weeks . After the kiwifruit intervention , plasma HDL-cholesterol ( HDL-C ) concentrations were significantly higher ( mean difference 0.04 ; 95 % CI 0.01 , 0.07 mmol/l ; P = 0.004 ) and the total cholesterol (TC):HDL-C ratio was significantly lower ( mean difference 20.5 ; 95 % CI 20.24 , 20.05 mmol/l ; P = 0.002 ) compared with the control . In carriers of the APOE4 allele , TAG decreased significantly ( mean difference -0.18 ; 95 % CI -0.34 , -0.02 mol/l ; P = 0.03 ) with kiwifruit compared with control . There were no significant differences between the two interventions for plasma TC , LDL-C , insulin , glucose , hs-CRP and BP . The small but significant increase in HDL-C and decrease in TC : HDL-C ratio and TAG ( in APOE4 carriers ) suggest that the regular inclusion of green kiwifruit as part of a healthy diet may be beneficial in improving the lipid profiles of men with high cholesterol Statins are extensively used to treat dyslipidemia , but , because of their low tolerability profile , they are discontinued in a significant proportion of patients . Ezetimibe and nutraceuticals have been introduced as alternative therapies and have proved to be effective and well tolerated . A single-blind , single-center , r and omized , prospect i ve , and parallel group trial comparing a combination of nutraceuticals ( red yeast rice , policosanol , berberine , folic acid , coenzyme Q10 and astaxanthin ) , called Armolipid Plus , and ezetimibe for 3 months in terms of efficacy and tolerability . Patients who did not achieve their therapeutic target ( low-density lipoprotein cholesterol < 100 mg/dl ) could add the alternative treatment on top of r and omized treatment for another 12 months : 100 patients who are dyslipidemic with ischemic heart disease treated with percutaneous coronary intervention were enrolled ( ezetimibe n = 50 , nutraceutical n = 50 ) . Efficacy ( lipid profile ) and tolerability ( adverse events , transaminases , and creatine kinase ) were assessed after 3 and 12 months . After 3 months , 14 patients in the nutraceutical group achieved their therapeutic target , whereas none of the patients in the ezetimibe group did . At 1-year follow-up , 58 patients ( 72.5 % ) of the combined therapy group ( n = 86 ) and 14 ( 100 % ) of the nutraceutical group reached the therapeutic goal . No patients experienced important undesirable effects . In conclusion , nutraceuticals alone or in combination with ezetimibe are well tolerated and improve the lipid profile in statin-intolerant patients with coronary heart disease . Further studies are needed to assess long-term effects of nutraceuticals on mortality Abstract Consumption of polyphenol-rich food and food ingredient such as grape and grape products improved various cardiovascular parameters . In this study , we investigate the effect of dietary daily consumption of red grape cell powder ( RGC ) on blood pressure ( BP ) and flow-mediated dilatation ( FMD ) as well as on oxidative stress in 50 subjects with prehypertension and mild hypertension . The subjects were r and omized into groups that consumed 200 , 400 mg RGC or placebo daily for 12 weeks . RGC consumption was associated with an improvement of FMD ( p = 0.013 ) . There was a significant decrease in lipid peroxidation ( p = 0.013 ) after 12 weeks in a combined RGC-treated group . The diastolic BP decreased significantly in the 200 mg RGC group compared to the placebo group ( p = 0.032 ) . Our results indicate that a daily supplementation , of red grape cell powder , for 12 weeks affects endothelial function , diastolic BP and oxidative stress without any adverse effects BACKGROUND AND AIMS Despite hypercholesterolemia has been recognized to increase cardiovascular risk in human immunodeficiency virus (HIV)-infected patients , cholesterol-lowering therapy is underused in this population , due to fear of drug-drug interactions with antiretroviral therapy ( ART ) . We investigated the effects of a nutraceutical combination ( NC ) on lipid profile , proprotein convertase subtilisin/kexin type 9 ( PCSK9 ) , sub clinical inflammation and arterial stiffness in ART-treated HIV-infected patients . METHODS This was a prospect i ve r and omized open-label trial with a cross-over design including 30 stable HIV-infected patients on ART with low-density lipoprotein cholesterol ( LDL-C ) > 115 mg/dL , not taking lipid-lowering treatment . After a 3-week lipid stabilization period , the effects associated with 3 months of an oral NC containing red yeast rice and berberine vs. no active treatment ( noNC ) were assessed for plasma total cholesterol ( TC ) , LDL-C , high-density lipoprotein cholesterol ( HDL-C ) , triglyceride ( TG ) , lipoprotein(a ) , PCSK9 , high-sensitivity C-reactive protein ( hs-CRP ) levels and aortic pulse wave velocity ( aPWV ) . RESULTS At baseline , significant correlations between PCSK9 levels , age ( rho = -0.51 , p=0.004 ) , waist circumference ( rho = 0.36 , p=0.005 ) and CD4 + cell count ( rho = -0.40 , p=0.027 ) were observed . NC treatment effects corrected for noNC were significant for TC ( -14 % , p<0.001 ) , LDL-C ( -19 % , p<0.001 ) , PCSK9 ( -12 % , p=0.02 ) , hs-CRP ( -14 % , p=0.03 ) and aPWV ( -6 % , p=0.005 ) . No significant effects were observed for HDL-C , TG and lipoprotein(a ) . NC treatment was safe and no significant alterations in muscle , liver and immunovirological parameters were observed . No carry over effect was recorded . CONCLUSIONS The tested NC significantly reduced plasma cholesterol and PCSK9 levels , attenuated sub clinical inflammation and improved arterial stiffness in stable HIV-infected patients on ART BACKGROUND We examined the cholesterol-lowering effects of a proprietary Chinese red-yeast-rice supplement in an American population consuming a diet similar to the American Heart Association Step I diet using a double-blind , placebo-controlled , prospect ively r and omized 12-wk controlled trial at a university research center . OBJECTIVE We evaluated the lipid-lowering effects of this red-yeast-rice dietary supplement in US adults separate from effects of diet alone . DESIGN Eighty-three healthy subjects ( 46 men and 37 women aged 34 - 78 y ) with hyperlipidemia [ total cholesterol , 5.28 - 8.74 mmol/L ( 204 - 338 mg/dL ) ; LDL cholesterol , 3.31 - 7.16 mmol/L ( 128 - 277 mg/dL ) ; triacylglycerol , 0.62 - 2.78 mmol/L ( 55 - 246 mg/dL ) ; and HDL cholesterol 0.78 - 2.46 mmol/L ( 30 - 95 mg/dL ) ] who were not being treated with lipid-lowering drugs participated . Subjects were treated with red yeast rice ( 2.4 g/d ) or placebo and instructed to consume a diet providing 30 % of energy from fat , < 10 % from saturated fat , and < 300 mg cholesterol daily . Main outcome measures were total cholesterol , total triacylglycerol , and HDL and LDL cholesterol measured at weeks 8 , 9 , 11 , and 12 . RESULTS Total cholesterol concentrations decreased significantly between baseline and 8 wk in the red-yeast-rice-treated group compared with the placebo-treated group [ ( x+/-SD ) 6.57+/-0.93 mmol/L ( 254+/-36 mg/dL ) to 5.38+/-0.80 mmol/L ( 208+/-31 mg/dL ) ; P < 0.001 ] . LDL cholesterol and total triacylglycerol were also reduced with the supplement . HDL cholesterol did not change significantly . CONCLUSIONS Red yeast rice significantly reduces total cholesterol , LDL cholesterol , and total triacylglycerol concentrations compared with placebo and provides a new , novel , food-based approach to lowering cholesterol in the general population OBJECTIVES The joint predictive value of lipid and C-reactive protein ( CRP ) levels , as well as a possible interaction between statin therapy and CRP , were evaluated for survival after angiographic diagnosis of coronary artery disease ( CAD ) . BACKGROUND Hyperlipidemia increases risk of CAD and myocardial infa rct ion . For first myocardial infa rct ion , the combination of lipid and CRP levels may be prognostically more powerful . Although lipid levels are often measured at angiography to guide therapy , their prognostic value is unclear . METHODS Blood sample s were collected from a prospect i ve cohort of 985 patients diagnosed angiographically with severe CAD ( stenosis > or = 70 % ) and tested for total cholesterol ( TC ) , low-density lipoprotein ( LDL ) , high-density lipoprotein ( HDL ) , and CRP levels .  Key risk factors , including initiation of statin therapy , were recorded , and subjects were followed for an average of 3.0 years ( range : 1.8 to 4.3 years ) to assess survival . RESULTS Mortality was confirmed for 109 subjects ( 11 % ) . In multiple variable Cox regression , levels of TC , LDL , HDL and the TC : HDL ratio did not predict survival , but statin therapy was protective ( adjusted hazard ratio [ HR ] = 0.49 , p = 0.04 ) . C-reactive protein levels , age , left ventricular ejection fraction and diabetes were also independently predictive . Statins primarily benefited subjects with elevated CRP by eliminating the increased mortality across increasing CRP tertiles ( statins : HR = 0.97 per tertile , p-trend = 0.94 ; no statins : HR = 1.8 per tertile , p-trend < 0.0001 ) . CONCLUSIONS Lipid levels drawn at angiography were not predictive of survival in this population , but initiation of statin therapy was associated with improved survival regardless of the lipid levels . The benefit of statin therapy occurred primarily in patients with elevated CRP OBJECTIVES Dried fruits , like their fresh homologues , contain relatively high concentrations of antioxidants . The aim of this study was to determine the health outcomes of raisin consumption on patients with diabetes . METHODS We examined the effects of dried grapes ( Vitis vinifera ) cultivated in Greece , namely Corinthian Raisins ( CR ) on blood pressure , fasting glucose , glucated hemoglobin ( HbA1c ) , lipid peroxidation , high-sensitivity C-reactive protein , antioxidant status , and cytokines in patients with type 2 diabetes mellitus ( T2DM ) . Forty-eight well-controlled patients with T2DM from the diabetes outpatient clinic of our hospital were recruited to a two-armed , r and omized , controlled , 24-wk prospect i ve intervention trial in order to examine the health outcomes of CR consumption . All participants were reported to consume less fruits and vegetables than the recommended amount of five servings daily . Participants in the intervention were instructed to consume CR equal to two fruit servings ( 36 g/d ) , replacing snacks with similar energy density twice during the day . Anthropometric and blood pressure measurements , assessment of dietary intake , and fasting blood draws were conducted at baseline and at week 24 . Also , phenolic compounds present in CR were analyzed in plasma of the patients . t Test for parametric data and Mann-Whitney test or Wilcoxon test for non-parametric data were performed . Significance was set at P < 0.05 . RESULTS Body weight , glycemic control , and lipid profile were not affected in either arm . Patients in the CR arm reduced their diastolic blood pressure and increased their total antioxidant potential significantly compared with baseline . The differences between the two groups at week 24 were significant . No change in high-sensitivity C-reactive protein was observed . A significant difference in plasma circulating p-hydroxybenzoic acid was observed between groups at the end of the trial . CONCLUSIONS Our study shows that naturally CR may improve health features in patients with well-controlled T2DM Our aim was to test , through a crossover , double-blind , placebo-controlled r and omized clinical trial , if a short-term treatment with 10 mg monacolins combined with antioxidants could improve lipid pattern , high-sensitivity C-reactive protein ( hs-CRP ) , and endothelial function in a small cohort of moderately hypercholesterolemic subjects . Thus , 25 healthy , moderately hypercholesterolemic subjects were consecutively enrolled and , after 4 weeks of stabilization diet , were r and omized to the sequence placebo followed by a washout , monacolins or monacolins followed by a washout , placebo , with each period being 4 weeks long . At each study step , a complete lipid pattern , safety parameters , hs-CRP , and endothelial function have been measured . When compared to the placebo phase , during monacolin treatment , patients experienced a more favorable percentage change in total cholesterol ( TC ) ( TC after monacolin treatment , −18.35 % ; TC after placebo treatment , −5.39 % ) , low-density lipoprotein cholesterol ( LDL-C ) ( LDL after monacolin treatment , −22.36 % ; LDL after placebo treatment , −1.38 % ) , non-high-density lipoprotein cholesterol ( HDL-C ) ( non-HDL after monacolin treatment , −22.83 % ; non-HDL after placebo treatment : −7.15 % ) , hs-CRP ( hs-CRP after monacolin treatment : −2.33 % ; hs-CRP after placebo treatment , 2.11 % ) , and endothelial function ( pulse volume displacement after monacolin treatment , 18.59 % ; pulse volume displacement after placebo treatment , −6.69 % ) . No significant difference was observed with regard to triglycerides , HDL-cholesterol , and safety parameters . On the basis of our data , we could demonstrate that a 10 mg monacolin nutraceutical treatment appears to safely reduce cholesterolemia , hs-CRP , and markers of vascular remodeling in moderately hypercholesterolemic subjects . These results need to be confirmed in larger patient sample s and in studies with longer duration The aim of this study was to assess the impact of conjugated linoleic acids ( CLAs ) , vitamin E , and combination of these nutrients on serum lipid profiles and blood pressure ( BP ) in patients with active rheumatoid arthritis ( RA ) . In a r and omized , double-blind , placebo-controlled trial , 87 patients with active RA were divided into four groups receiving one of the following daily supplements for three months : Group C : CLAs 2.5 g equivalent to 2 g mixture of cis 9-trans 11 and trans 10-cis12 CLAs in a rate of 50/50 ; Group E : vitamin E : 400 mg ; Group CE : CLAs and vitamin E at above doses : Group P : placebo . After supplementation , SBP levels decreased significantly in the group C in comparison with groups E and P and mean arterial pressure reduced significantly in groups C and CE . There were n’t significant differences in the levels of prostagl and in E2 ( PGE2 ) , triglycerides , cholesterol , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , LDL/HDL , cholesterol/HDL , fasting blood sugar , C-reactive protein ( CRP ) , arylestrase activity , platelet count and body mass index between groups . CRP dropped nonsignificantly in groups P , C , E and CE ( 19 % , 24 % , 55 % , and 39 % , respectively ) . Erythrocytes sedimentation rate levels decreased in groups C , E and CE ( P ≤ 0.05 , P ≤ 0.05 , P ≤ 0.001 , respectively ) . It is concluded that supplementation of CLAs  decreased BP  and vitamin E  decreased CRP . Therefore cosupplementation of CLAs and vitamin E might be profitable for heart disease prevention in RA patients Background Statins are at the forefront of strategies to manage hypercholesterolemia . However 10 % to 15 % of patients are intolerant to any statin drugs , even at low daily doses and almost one-third of statin users discontinue therapy within 1 year . Some nutraceuticals are prescribed as lipid-lowering substances , but doubts remain about their efficacy and tolerability . Objectives We aim ed to investigate the efficacy and the safety of a nutraceutical combination consisting mainly of 200 mg red yeast rice extract ( equivalent to 3 mg monacolins ) , 500 mg berberine , and 10 mg policosanols ( MBP-NC ) in patients with low-moderate risk hypercholesterolemia . Methods In this single centre , r and omized , double-blind , placebo-controlled study 60 consecutive out patients ( 29 men and 31 women ; age range = 18–60 years ) , with newly diagnosed primary hypercholesterolemia not previously treated , after a run-in period of 3 weeks on a stable hypolipidic diet , were r and omized to receive a pill of MBP-NC ( n = 30 ) or placebo ( n = 30 ) once a day after dinner , in addition to the hypolipidic diet . The efficacy and the tolerability of the proposed nutraceutical treatment were fully assessed after 4 , 12 , and 24 weeks of treatment . Results In the MBP-NC group both total cholesterol and LDL-C already showed a significant reduction at Week 4 ( –30.3 % ± 33.9 % and –29.4 % ± 35.3 % , respectively ) that remained substantially unchanged at Week 12 ( –26.7 % ± 33.1 % and –25.6 % ± 31.5 % , respectively ) and at Week 24 ( –24.6 % ± 32.1 % and –23.7 % ± 32.6 % , respectively ) . The between-groups differences were significant at all time points for both total cholesterol and LDL-C. There were no significant changes in HDL-C , fasting glucose , and triglyceride serum levels in either group . MBP-NC  was also safe and well tolerated . Conclusions In patients with low- to moderate-risk hypercholesterolemia  a nutraceutical combination in association with a hypolipidic diet  significantly reduced total cholesterol and LDL-C levels and may favor the reaching the recommended cholesterol targets . Clinical Trials.gov identifier : NCT02078167 BACKGROUND Small studies have suggested that lipid-lowering strategies , and particularly statins , could influence blood pressure ( BP ) control . The aim of the present study was to evaluate the effect of different lipid-lowering strategies on BP control of subjects with hypercholesterolemia who were enrolled in the prospect i ve , population -based , longitudinal Brisighella Heart Study . METHODS A total of 1356 subjects with total cholesterol levels > or=239 mg/dL were r and omly treated for 5 years ( 1988 - 1993 ) with 1 of these lipid-lowering regimens : low-fat diet , cholestyramine , gemfibrozil , or simvastatin . Participants were divided at baseline into 4 quartiles according to systolic BP level and examined for the percent change in systolic and diastolic BP during the 5 years of treatment . RESULTS A significant decrease in BP was observed in the 2 upper quartiles of systolic BP ( > or=140 mm Hg ) and was greater in subjects treated with cholesterol-lowering drugs who also had a greater reduction in plasma levels of low-density lipoprotein cholesterol . The BP decrease was greater in patients treated with statin drugs and , among those treated with antihypertensive drugs , in subjects in the fourth quartile . CONCLUSION The use of lipid-lowering measures could significantly improve BP control in subjects with both hypercholesterolemia and hypertension . The reduction in BP seems to be enhanced in subjects treated with statins BACKGROUND Type 2 diabetes mellitus ( T2DM ) is a major public health problem worldwide . Hypertension and inflammation are well recognized as risk factors for the macrovascular complications of diabetes . The aim of this study was to assess the impact of vitamin E supplementation on blood pressure ( BP ) , serum high-sensitivity C-reactive protein ( hs-CRP ) and fasting blood glucose in patients with T2DM . METHODS In a double blind , r and omized , controlled clinical trial , 83 patients with T2DM were divided r and omly into two groups of vitamin E ( 400 mg/d , n=42 ) and placebo ( n=41 ) . All patients received the pearls for 8 weeks . Baseline and eighth week BP , serum hs-CRP , fasting blood glucose , anthropometric and dietary intake data were obtained from each patient . Data were analyzed using SPSS version 11.5 . RESULTS Vitamin E supplementation significantly increased serum levels of vitamin E  ( P < 0.001 ) and decreased mean arterial pressure and fasting blood glucose ( P = 0.047 , P = 0.028 , respectively ) in vitamin E group as compared with placebo group . A significant decrease in systolic blood pressure and diastolic blood pressure was observed in the vitamin E group comparing with baseline values ( all P < 0.01 ) . There were no significant changes in serum hs-CRP in both of the studied groups . CONCLUSION Vitamin E had beneficial effects on serum vitamin E , BP and blood glucose in patients with T2DM . Improvement in BP and glucose control may contribute to reducing complications of diabetes including cardiovascular risk in these patients Coronary heart disease , hypertension , and dyslipidemia are highly prevalent and commonly coexist in people who are middle-aged and older . Previous data suggested that lowering cholesterol concentrations in individuals at high risk of cardiovascular disease improved clinical outcomes . Xuezhikang , a partial extract of red yeast rice containing statin , has a marked impact on lipids . The purpose of this study , therefore , was to evaluate the impact of Xuezhikang on reducing cardiovascular events and mortality in elderly Chinese hypertensive patients with a history of myocardial infa rct ion ( MI ) enrolled in the Chinese Coronary Secondary Prevention Study . In this r and omized trial , 1530 elderly hypertensive patients ( > or = 65-years-old ) with previous MI were assigned either to placebo ( n = 758 ) or to Xuezhikang ( n = 772 ) daily for an average of 4.5 years . The primary endpoint was recurrent coronary events ; the secondary endpoint was all-cause mortality and other clinical events , including adverse effects . There were 68 cases of coronary events ( 8.8 % ) detected in the Xuezhikang group and 108 cases ( 14.3 % ) in the placebo group ( 38.2 % risk reduction by Xuezhikang therapy ) . Death from coronary heart disease ( CHD ) totaled 49 cases in the Xuezhikang group ( 6.4 % ) and 68 cases in the placebo group ( 9.0 % ) , indicating that Xuezhikang significantly decreased the risk of CHD death by 29.2 % . Our study demonstrated that Xuezhikang therapy could effectively and safely reduce cardiovascular events and all-cause death in Chinese elderly hypertensive patients with previous MI . This finding may have an important implication for the treatment of elderly hypertensive patients with CHD
“ RYR plus conventional therapy ” exhibited significant lowering effects on serum total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) , and CRP but exhibited no significant effect on systolic BP , diastolic BP , triglycerides ( TG ) , and high-density lipoprotein cholesterol ( HDL-C ) compared with “ placebo plus conventional therapy . ” “
RYR plus conventional therapy ” showed significant lowering effects on systolic BP , TC , LDL-C , and CRP but no effect on diastolic BP , TG , and HDL-C compared with “ placebo plus conventional therapy . ”
No significant difference in BP and lipid profile between “ RYR plus conventional therapy ” and “ statins plus conventional therapy ” was observed .
“ RYR plus statins ” appeared to be more effective in lowering BP , TC , TG , and LDL-C but without a significant difference in HDL-C compared to statins .
No serious adverse events were reported .
The results of this meta- analysis suggested some supportive but limited evidence regarding RYR for hypertension .
ABSTRACT Interest is increasing regarding the potential health effects of red yeast rice ( RYR ) consumption , which is described as a “ natural statin ” in China .
This review aims to evaluate the efficacy of RYR on blood pressure ( BP ) , lipid profile , and C-reactive protein ( CRP ) in treating  hypertension .