Nutraceutical combination (red yeast rice, berberine and policosanols) improves aortic stiffness in low-moderate risk hypercholesterolemic patients

•Hypercholesterolemia is important in the pathogenesis of arterial stiffness.•In previous studies, some nutraceuticals reduced cholesterol levels.•The nutraceutical combination allowed 65% patients to reach the LDL target.•The nutraceutical combination reduced significantly aortic stiffness.•In mild hypercholesterolemia, some nutraceuticals may have a beneficial role.

Hypercholesterolemia is important in the pathogenesis of arterial stiffness. Treatment with a combination of red yeast rice, berberine and policosanols reduced cholesterol levels in hypercholesterolemic patients. We investigated whether this nutraceutical combination would improve aortic stiffness in hypercholesterolemia.Seventy hypercholesterolemic patients were assigned to oral nutraceutical combination (NC, red yeast rice 200 mg, berberine 500 mg and policosanols 10 mg) or no active treatment (noNC). Lipid levels and aortic pulse wave velocity (aPWV) were assessed before and after treatment.NC reduced low-density lipoprotein (LDL) cholesterol by 20%. More than 65% patients reached the recommended LDL cholesterol target. A significant difference in the response of aPWV to treatments (NC vs noNC) was found (p = 0.005): NC was associated with a reduction in aPWV (from 9.1 ± 2.0 to 8.3 ± 1.7 m/s, p < 0.001), whereas no change was observed in the noNC arm. LDL cholesterol reduction was associated with improvement in aPWV (r = 0.30, p = 0.01). In regression analyses, NC was associated with the presence of aPWV amelioration (OR and 95% CI, 4.2, 1.4–12.5) and the degree of aPWV reduction (β = 0.33, p = 0.007).In conclusion, in patients with hypercholesterolemia, the nutraceutical combination reduced cholesterol levels and improved aPWV. An association between cholesterol reduction and aortic stiffness was found.

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