The effect of red yeast rice on dyslipidemia: an evidencie-based review

Ana Rita Rocha, Joana Alves Ferreira, João Mendes Sobral, Samuel Pinto

Background:

Dyslipidemia is a common health issue with a known major impact in cardiovascular diseases. Controlling cardiovascular risk factors, especially with regard to the LDL cholesterol levels, is preponderant to reduce morbidity and mortality. Statins remain the first line in the treatment of dyslipidemia, but there is a growing interest in alternative products. Red yeast rice (RYR) is a nutraceutical with cholesterol-lowering properties, therefore with a possible impact on the prevention of cardiovascular events.

Research questions:

Our goal is to investigate the lipid-lowering abilities of RYR supplements, its efficiency and its safety for use in dyslipidemic patients.

Method:

The present study is an evidence-based review. A research of the Pubmed database was made in April of 2023, using the MeSH terms “red yeast rice” and “dyslipidemia”. Studies from the last ten years, in portuguese or english, with public access, that included the use of RYR or its known active substance, monacolin K, in monotherapy were considered. The data collection included the type of study, dose of supplement used, effect on LDL cholesterol and safety assessment, when mentioned.

Results:

Thirteen studies were included, according to eligibility criteria. All studies demonstrated a reduction of LDL cholesterol levels with the use of RYR. This reduction varied from 20,7 to 60,7 mg/dL, which is justified by the different doses administered in the different studies. There were no severe adverse effects registered. Additionally, several studies have demonstrated the benefits of RYR in reducing the incidence of coronary disease and cardiovascular-related deaths.

Conclusions:

RYR demonstrates a clinically and statistically significant reduction of LDL cholesterol levels. This might represent a safe and effective treatment option for dyslipidemia and cardiovascular risk reduction in statin-intolerant patients.

Points for discussion:

Is red yeast rice effective in controlling dyslipidemia?

In which patients does red yeast rice represent a treatment option?

Does red yeast rice improve cardiovascular outcomes?

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