Effects of Nutraceuticals and Botanicals on Macrophage Cholesterol Efflux: Implications for Atherosclerosis

To date, the literature on high-density lipoprotein (HDL) levels as an inverse risk factor for atherosclerosis has mainly been observational, and it is likely that the metabolism and function of HDL is a more significant determinant of cardiovascular disease. As an example, as cholesterol is effluxed out of macrophages and carried to the liver via HDL for excretion, reduced cholesterol efflux can result in increased cholesterol accumulation. In terms of atherosclerosis risk, increasing cholesterol efflux is theoretically a strategy that can be considered as the groundwork of cardiovascular disease treatment and prevention. However, until now, there has not been a pharmaceutical agent that has effectively increased reverse cholesterol transport (RCT) at all steps of the process. Here is a review of the research on natural compounds present in edible foods and their observed in vitro and in vivo (and even ex vivo) effects on the first step of RCT: macrophage cholesterol efflux. The findings here are preliminary and contradictory, making it hard to translate the evidence on most of these naturally occurring agents into clinical applications

Valsartan in a Japanese population with hypertension and other cardiovascular disease (Jikei Heart Study): a randomised, open-label, blinded endpoint morbidity-mortality study. Lancet 369

Summary Background Drugs that inhibit the renin-angiotensin-aldosterone system benefi t patients at risk for or with existing cardiovascular disease. However, evidence for this eff ect in Asian populations is scarce. We aimed to investigate whether addition of an angiotensin receptor blocker, valsartan, to conventional cardiovascular treatment was eff ective in Japanese patients with cardiovascular disease

HDL Functions—Current Status and Future Perspectives

Cardiovascular disease (CVD) is the leading cause of death in Western countries. A low HDL-C is associated with the development of CVD. However, recent epidemiology studies have shown U-shaped curves between HDL-C and CVD mortality, with paradoxically increased CVD mortality in patients with extremely high HDL-C levels. Furthermore, HDL-C raising therapy using nicotinic acids or CETP inhibitors mostly failed to reduce CVD events. Based on this background, HDL functions rather than HDL-C could be a novel biomarker; research on the clinical utility of HDL functionality is ongoing. In this review, we summarize the current status of HDL functions and their future perspectives from the findings of basic research and clinical trials