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Complementary and alternative therapies for the management of dyslipidemia.

Nies LK, Cymbala AA, Kasten SL, Lamprecht DG, Olson KL

Department of Pharmacy, Kaiser Permanente of Colorado, Aurora, CO 80011-9045, USA.

OBJECTIVE: To review the literature on select alternative therapies for the management of dyslipidemia. DATA SOURCES: Searches of MEDLINE and PubMed (1965-March 2006) were conducted using the key terms omega-3-fatty acids, policosanol, plant stanols and sterols, flaxseed, red yeast rice, guggulipid, garlic, fiber, almonds, and cholesterol and/or lipids. STUDY SELECTION AND DATA EXTRACTION: Meta-analyses, published in English and involving adults, that incorporated randomized, controlled trials on alternative therapies for dyslipidemia were reviewed. Additionally, trials published subsequent to the meta-analyses were reviewed. Articles deemed relevant were included in this review. DATA SYNTHESIS: Of the aforementioned alternative therapies, randomized controlled trials were found for omega-3-fatty acids, policosanol, plant stanols and sterols, flaxseed, red yeast rice, guggulipid, garlic, fiber, almonds, and soy. Studies for each of these agents report varying degrees of lipid reduction. Based on published data, effective therapeutic options for lipid-lowering include intake of fiber, intake of plant stanols/sterols, replacement of animal protein with soy protein, and substitution of foods high in saturated fat with those with monounsaturated fatty acids (eg, dry roasted almonds). Adding omega-3-fatty acids is effective for reducing triglycerides in patients with hypertriglyceridemia. Well-designed studies with long-term outcome data are necessary to further define the role for guggul, red yeast rice, policosanol, garlic, and flaxseed in the management of dyslipidemia. CONCLUSIONS: Alternative therapeutic approaches with complementary therapies are becoming increasingly popular among patients. It is important for healthcare providers to be familiar with the safety and efficacy of these agents to facilitate optimal outcomes for patients with dyslipidemia.

Published 1 November 2006 in Ann Pharmacother, 40(11): 1984-92.
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