LDL- and HLD-Cholesterol Optimization Using Phytonutrient Combination Therapy

摘要

Lipid parameter optimization (total cholesterol TC, low density lipoprotein LDL-c, high density lipoprotein HDL-c, and triglycerides TG) is considered a primary target for controlling the long-term risk of developing cardiovascular disease (CVD), including coronary heart disease, and stroke. For other health concerns, such as the metabolic syndrome, and resulting type 2 diabetes, similar goals are formulated. Over the years focus has shifted on controlling TC to mainly lowering LDL-c. Today, as determined by Framingham risk score analysis, CVD risk is most effectively reduced by lowering LDL-c and TG, and increasing HDL-c simulta-neously.[1] To reach these individual goals a multitude of diet and lifestyle options, combined with pharmaceutical interventions is available. The National Cholesterol Education Program of the National Institutes of Health advises to adhere to the Therapeutic Lifestyle Changes Diet (TLC) as a first defense against CVD, and related disorders.[2] Given all these options, heart disease is still the number-one cause of mortality in the world. [3] Several reasons can be suggested for this disconnect. First, adherence to diets, such as the TLC, is difficult, in particular for the population group that is most prone to the development of CVD. Second, compliance with pharmaceutical treatment regimens lingers over time. There is a growing group of patients that can not tolerate lipid lowering therapy or choose not to take it, because of side-effect concerns. Incidence of side-effects caused by statins may be rather small, but since combining medications, as is increasingly common these days, may augment the side-effect profile of individual drugs, overall side-effect incidence has increased among pharmaceutical product users.[4] It is not uncommon these days for health care professionals to be confronted by patients that insist on having a natural non-pharmaceutical prescription option. The nutrition sciences have investigated many natural dietary options for managing sub-optimal lipid levels. These options, however, typically exert mild effects that limit their clinical relevance for immediate lipid lowering.