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Intermittent Claudication (IC)
Published in Charles Theisler, Adjuvant Medical Care, 2023
Policosanol is a dietary supplement made of medium-chain alcohols extracted from sugar cane. Policosanol has favorable effects on intermittent claudication, possibly due to its effects on platelet aggregation and endothelial function.
Nutrition and Nutritional Supplements in the Management of Dyslipidemia and Dyslipidemia-Induced Cardiovascular Disease
Published in Stephen T. Sinatra, Mark C. Houston, Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
Policosanol is a sugar cane extract of eight aliphatic alcohols that has undergone extensive clinical studies with variable results [5,136–139]. Most of the earlier studies that showed positive results were performed in Cuba, and these have been questioned as to their validity [5,137]. More recent double-blind placebo-controlled clinical trials have not shown any significant improvement in any measured lipids including TC, LDL-C, TG, or HDL-C. A recent small study (14 subjects, underpowered) suggested that policosanol may improve HDL-C functionality, increase paraoxonase (PON), lower glucose, reduce uric acid, decrease blood pressure and the oxidative stress marker malondialdehyde (MDA), and improve the lipid profile [136]. Other studies have found that policosanol may enhance the effects of statins and improve hepatic function [139]. Policosanol is not recommended at this time for the treatment of any form of dyslipidemia pending more definitive studies with a larger study population [5,137,138].
Macronutrients
Published in Chuong Pham-Huy, Bruno Pham Huy, Food and Lifestyle in Health and Disease, 2022
Chuong Pham-Huy, Bruno Pham Huy
Policosanol is a dietary supplement marketed in the Caribbean, Central and South America, and Canada. Human policosanol consumption is safe and well tolerated and is effective at lowering the blood cholesterol (140–141). Policosanol has been reported to improve blood pressure, lipid profile, and HDL functionality via inhibition of cholesteryl ester transfer protein both in vitro and in vivo in zebrafish and human models (141). However, the anti-hypercholesterolemia effects of policosanol in sugarcane wax are still not officially confirmed by healthcare organizations.
New and developing pharmacotherapies for hypertension
Published in Expert Review of Cardiovascular Therapy, 2022
Christian Höcht, Miguel A Allo, Ariel Héctor Polizio, Marcela A Morettón, Andrea Carranza, Diego A Chiappetta, Marcelo Roberto Choi
Different foods may exert pro-, pre-, post-, and symbiotic effects, displaying antihypertensive properties or improving the response to antihypertensive drugs [125]. Some examples are the ingestion of yogurt (as probiotic/prebiotic food), kefir or plant-based fermented foods, and drinks such as kimchi and kombucha, all of them capable of modulating gut microbiota homeostasis and significantly associated with BP reduction [126–129]. It has also been reported that kefir positively influences endothelial progenitor cells recruitment, ACE inhibition, oxidative stress reduction, and stimulates anti-inflammatory cytokines production [130]. In experimental and clinical hypertension settings, such as SHR rats and patients with mild hypertension, it has been shown that the fermentation of milk proteins by L. helveticus LBK-16H generates tripeptides that exert an inhibitory activity on ACE and displays a lowering effect on BP [131,132]. Bioactive compounds like policosanol isolated from sorghum, and anthocyanins present in the dark-colored fruits and some vegetables and grains also display a beneficial effect on glucose homeostasis and improve oxidative stress and inflammation parameters related to cardiovascular and metabolic pathologies, including arterial hypertension [133]. Another approach to improve BP control is the Mediterranean diet, which includes bioactive compounds such as prebiotics, probiotics, polyphenols, fiber, polyunsaturated fatty acids (PUFA) ω-3, and dietary polysaccharides, and can reduce the gut dysbiosis marker (Firmicutes/Bacteroidetes ratio) [134].
The Beneficial Radioprotective Effect of Tomato Seed Oil Against Gamma Radiation–Induced Damage in Male Rats
Published in Journal of Dietary Supplements, 2018
Magda K. Ezz, Nashwa K. Ibrahim, Mahmoud M. Said, Mostafa A. Farrag
Policosanol is a mixture of long-chain linear fatty alcohols (n-alkanols), and among the detected policosanols in TSO are docosanol, which has an anti–herpes simplex virus activity; hexacosanol, which protects the kidney from diabetic nephropathy in rats; and octacosanol, which has cytoprotective effects (Giuffrè and Capocasale, 2015). TSO is also rich in two essential fatty acids (EFA), linoleic and linolenic acids, and therefore, the edible can be used as a dietary supplement in EFA-deficient diets (Giuffrè and Capocasale, 2016a). Furthermore, TSO was reported to be a potent antioxidant in THP-1 cells, reducing oxidant-induced intracellular reactive oxygen species production, modulating the redox-sensitive MAPK/NF-κβ pathway, and inhibiting expression of oxidative stress–induced proteins, including hsp70 and 90 (Müller et al., 2013).
Future perspectives of the pharmacological management of diabetic dyslipidemia
Published in Expert Review of Clinical Pharmacology, 2019
Angelo Maria Patti, Rosaria Vincenza Giglio, Nikolaos Papanas, Manfredi Rizzo, Ali A. Rizvi
The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements on the management of T2DM in adults. With regards to medication management, for patients with clinical cardiovascular disease, a sodium-glucose cotransporter 2 (SGLT2) [132] inhibitor or a glucagon-like peptide 1 (GLP-1) receptor agonist with proven cardiovascular benefit is recommended; GLP-1 receptor agonists are generally recommended as the first injectable medication [133,134]. Current guidelines recommend a combination of risk stratification and LDL-C reduction in patients with diabetic dyslipidemia [12,13,135,136]. Pharmacological management of diabetic dyslipidemia can be achieved by selecting the appropriate therapy or combination of therapies used to provide patients with personalized treatment. Statins are the first-line treatment [12,33,137,138] and ezetimibe should be used in patients who fail to reach the target level of LDL-C with statins alone or if they are intolerant to statins [12,43]. In patients with established cardiovascular disease, residual cardiovascular risk persists despite the achievement of target low-density lipoprotein (LDL) cholesterol levels with statin therapy. Among patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of less than 70 mg per deciliter (1.81 mmol/L), the addition of niacin to statin therapy during a 36-month follow-up period does not increment clinical benefit from despite significant improvements in HDL cholesterol and triglyceride levels [139]. PCSK9, alone or with statins and ezetimibe should be reserved for patients at high risk with clinical ASCVD and LDL-C above the target level [62,66]. Fibrates may be considered in high-risk patients with high TG levels and low HDL-C levels [33,52]. New anti-diabetic drugs have pleiotropic effects on various cardiovascular risk factors [75]. In addition to having a direct action on the lipid pattern [79,80], they also have an indirect action on lipid oxidation [140] and on subclinical atherosclerosis [76] and may therefore be beneficial in T2DM patients with cardiovascular complications. Finally, nutraceuticals can help selected patients achieve therapeutic lipid targets [131,141] and reduce residual cardiovascular risk. Positive effects of a nutraceutical combination comprising red yeast rice, berberine, policosanol, astaxanthin, coenzyme Q10 and folic acid on plasma lipid and glucose levels have been reported in some clinical trials; there were a strong impact of this combination supplementation on plasma levels of total cholesterol (−26.15mg/dL, p < 0.001), LDL-cholesterol (−23.85mg/dL, p < 0.001), HDL-cholesterol (2.53mg/dL, p < 0.001), triglycerides (−13.83mg/dL, p < 0.001), glucose (−2.59mg/dL, p = 0.010) [142] and on additional surrogate markers of cardiovascular risk, including inflammation and endothelial injury, which have been associated with atherosclerotic and CV risk [143–147].