Abstract
More than 200 clinical trial reports and several meta-analyses have demonstrated that
phytosterols (PSs), natural components of plants, induce clinically relevant reductions
in blood low-density lipoprotein cholesterol levels. Here we review data regarding
the biochemical effects and potential cardiovascular benefit of PSs as part of the
dietary management of dyslipidemia. In addition to discussing the efficacy, effectiveness,
and safety of PSs as hypocholesterolemic agents, this review provides an overview
of PSs as an adjunctive therapy to cholesterol-lowering pharmaceuticals. Given this
lack of evidence regarding the benefits of PSs for reducing cardiovascular end points,
this review also discusses the present knowledge that exists about the ability for
therapeutic dosages of PSs to confer protection from cardiovascular-related mortality
and morbidity. Finally, this review summarizes the factors that affect PS efficacy
and the Canadian regulations that govern the use of PSs as cholesterol-lowering agents
in foods and supplements.
Résumé
Plus de 200 comptes rendus d’essais cliniques et plusieurs méta-analyses ont démontré
que les phytostérols (PS), des composants naturels des végétaux, induisent des réductions
cliniquement pertinentes des concentrations sanguines de cholestérol à lipoprotéines
de faible densité. Ici, nous passons en revue les données concernant les effets biochimiques
et les bienfaits potentiels des PS sur la santé cardiovasculaire dans le cadre de
la prise en charge nutritionnelle de la dyslipidémie. En plus de traiter de l’efficacité
réelle et potentielle, et de l’innocuité des PS en tant qu’hypocholestérolémiants,
cette revue donne un aperçu des PS utilisés comme traitement d’appoint aux médicaments
hypocholestérolémiants. Étant donné le manque de données concernant les bienfaits
des PS sur la réduction des critères de jugement cardiovasculaires, cette revue traite
également des connaissances actuelles sur la capacité des phytostérols à doses thérapeutiques
à offrir une protection contre la mortalité et la morbidité liées à la maladie cardiovasculaire.
Finalement, cette revue résume les facteurs qui affectent l’efficacité des PS et les
règlements canadiens qui régissent l’utilisation des PS en tant qu’hypocholestérolémiants
dans les aliments et les suppléments.
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Article info
Publication history
Published online: April 28, 2014
Accepted:
April 7,
2014
Received:
November 25,
2012
Footnotes
See page 1230 for disclosure information.
See editorial by Brahm and Hegele, pages 1142-1144 of this issue.
Identification
Copyright
© 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
