Center for Human Nutrition, University of California, Los Angeles, 900 Veteran Avenue,
Room 12-217, Los Angeles, CA 90095-1742, USA. dheber@mednet.ucla.edu
[Record supplied by publisher]
It is now widely accepted that atherosclerosis is a complex multicellular process
involving oxidation of cholesterol and the intracellular accumulation of oxidized
cholesterol. This accumulation causes a cascade of inflammatory processes, resulting in an
unstable atherosclerotic plaque that ultimately bursts, causing myocardial infarction.
Botanical dietary supplements (herbs) can ameliorate this process and prevent
cardiovascular disease at many steps in the process. Many herbs have antioxidant activity
and can reduce low-density lipoprotein oxidation. Some phytosterols found in botanicals
can inhibit cholesterol absorption. After a brief review of herbs being promoted for
achieving and maintaining healthy cholesterol levels, the evidence and future prospects
for Chinese red yeast rice, the main component of dietary supplements with HMG-CoA
reductase inhibiting activity, are discussed in detail. Initial phase II clinical trials
are highly encouraging. This herb is likely to be able to directly impact the process of
atherosclerosis, but large-scale clinical trials are needed to assess the public health
potential of this herbal supplement.