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Lipid-Lowering Efficacy of Red Yeast Rice in a Population Intolerant to Statins

      Chinese red yeast rice is a dietary supplement containing monacolins, unsaturated fatty acids, and phytosterols capable of lowering low-density lipoprotein (LDL) cholesterol. Few studies have reported on its use in clinical practice or in statin-intolerant patients. We reviewed approximately 1,400 clinical charts and identified 25 patients treated with red yeast rice for ≥4 weeks. The patients were included if they had pre- and post-treatment lipid levels without simultaneous changes in other lipid-lowering medications. These patients had experienced myalgias (68%), gastrointestinal intolerance (16%), and/or elevated alanine aminotransferase levels (8%) with previous use of other lipid-lowering agents. The total cholesterol decreased 15% (−37 ± 26 mg/dl, p <0.001) and LDL cholesterol decreased 21% (−35 ± 25 mg/dl, p <0.001) during 74 ± 39 days of treatment. Most (92%) patients tolerated the treatment, and many (56%) achieved their LDL cholesterol goal. In patients unable to tolerate daily statin use, the total cholesterol level decreased 13% (−33 ± 10 mg/dl, p <0.001) and LDL cholesterol decreased 19% (−31 ± 4 mg/dl, p <0.001). In conclusion, red yeast rice modestly decreased total and LDL cholesterol, was well-tolerated, and was an acceptable alternative in patients intolerant of other lipid-lowering medications.
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      Linked Article

      • All Red Yeast Rice Products Are Not Created Equal—or Legal
        American Journal of CardiologyVol. 106Issue 3
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          The American Journal of Cardiology recently published a reported titled “Lipid-Lowering Efficacy of Red Yeast Rice in a Population Intolerant to Statins.”1 The investigators reported that 25 patients with known histories of intolerance to statin drugs, when treated with red yeast rice, averaged a 21% decrease in low-density lipoprotein cholesterol, with few side effects. In this uncontrolled study, patients were allowed to purchase their own choices of red yeast rice products, and their selections were not reported.
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