[Nutraceuticals: a useful tool for cardiologists to improve lipid profile?]

Hyperlipidemia is a major risk factor for cardiovascular morbidity and mortality. Treatment strategies include both lifestyle modification and pharmacological therapy. Statins are among the most effective agents to achieve optimal LDL-cholesterol levels, but, not infrequently, patients suffer from myalgia or other side effects. The proven or perceived intolerance to statins requires, therefore, alternative lipid-lowering strategies. In recent years, nutraceuticals have become extensively accepted, and a growing number of molecules with hypothetical cholesterol-lowering activity have been proposed, sometimes with no scientific evidence and/or no methodological accuracy, based only on the belief that these agents are "natural" and do not show side effects. Here, nutraceuticals with potential evidence-based hypolipidemic effect will be reviewed (red yeast rice, berberine, phytosterols) in order to discuss their role in lipid control, their potential risks and their future prospective in clinical cardiology.