Natural polypill xuezhikang: Its clinical benefit and potential multicomponent synergistic mechanisms of action in cardiovascular disease and other chronic conditions

Journal of Alternative and Complementary Medicine

Volumn 18, Issue 4, 2012, Pages 318-328

  Feng, Yan ^a   Xu, Hao ^b   Chen, Keji ^b  

^a INSTITUTE OF CHINESE MATERIA MEDICA   (China)

^b XIYUAN HOSPITAL   (China)

Author keywords

[No Author keywords available]

Indexed keywords

FLAVONOID; MEVINOLIN; OMEGA 3 FATTY ACID; SELENIUM; VALSARTAN; XUEZHIKANG;

ACUTE CORONARY SYNDROME; ANTIHYPERTENSIVE ACTIVITY; ANTIINFLAMMATORY ACTIVITY; ANTINEOPLASTIC ACTIVITY; ATHEROSCLEROSIS; CARDIOVASCULAR DISEASE; CHRONIC DISEASE; DRUG EFFICACY; DRUG MECHANISM; DRUG POTENTIATION; ESSENTIAL HYPERTENSION; FATTY LIVER; FEASIBILITY STUDY; HEART LEFT VENTRICLE HYPERTROPHY; HEART VENTRICLE REMODELING; HUMAN; HYPERLIPIDEMIA; INSULIN RESISTANCE; ISCHEMIC HEART DISEASE; LIVER PROTECTION; NEOPLASM; NEPHRITIS; NONALCOHOLIC FATTY LIVER; NONHUMAN; OBESITY; PRIORITY JOURNAL; RENAL PROTECTION; REVIEW; UNSTABLE ANGINA PECTORIS;

BIOLOGICAL AGENTS; CARDIOVASCULAR DISEASES; DRUG SYNERGISM; DRUGS, CHINESE HERBAL; HUMANS; HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITORS; LIPIDS; MONASCUS; NEOPLASMS; PHYTOTHERAPY;

EID: 84862075975     PISSN: 10755535     EISSN: 15577708     Source Type: Journal    
DOI: 10.1089/acm.2011.0187     Document Type: Review

References (89)

1. World Health Organization. TheWorld Health Report 2003- Shaping the Future. Online document at: www.who.int/whr/2003/en/ Accessed April 2, 2012.
2. Emberson J, Whincup P, Morris R, et al. Eur Heart J 2004; 25:484-491.
3. Dezii CM. A retrospective study of persistence with singlepill combination therapy vs. concurrent two-pill therapy in patients with hypertension. Manag Care 2000;9(suppl): S2-S6.
4. Wald NJ and Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ 2003;326:1419.
5. Rodgers A. A cure for cardiovascular disease? BMJ 2003;326: 1407-1408. (Pubitemid 36776146)
6. Willis J. Polypill debate continues: Concept is a fascinating thought experiment. BMJ 2004;328:289. (Pubitemid 38168151)
7. Reddy KS. The preventive polypill: Much promise, insufficient evidence. NEJM 2007;356:212. (Pubitemid 46143223)
8. Gaziano TA, Opie LH, Weinstein MC. Cardiovascular disease prevention with a multidrug regimen in the developing world: A cost-effectiveness analysis. Lancet 2006;368: 679-686.
9. Soliman EZ, Mendis S, Dissanayake WP, Somasundaram NP, Gunaratne PS, Jayasingne IK, et al. A Polypill for primary prevention of cardiovascular disease: A feasibility study of the World Health Organization. Trials 2011;12:3.
10. Zhang ML, Duan ZW, Xie SM. Study on the active ingredient of Xuezhikang. Chin J New Drugs (Chin) 1998;7: 213-214.
11. Journoud M, Jones PJ. Red yeast rice: A new hypolipidemic drug. Life Sci 2004;74:2675.
12. Liu J, Zhang J, Shi Y, et al. Chinese red yeast rice (Monascus purpureus) for primary hyperlipidemia: A meta-analysis of randomized controlled trials. Chin Med 2006;1:4.
13. Lu Z, Kou W, Du B, et al. Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction. Am J Cardiol 2008;101:1689-1693.
14. Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Chin J Cardiol (Chin) 2007;35: 390-419.
15. Pfeffer MA, Sacks FM, Moyé LA, et al. Cholesterol and recurrent events: A secondary prevention trial for normolipidemic patients. CARE Investigators. Am J Cardiol 1995; 76:98C-106C.
16. Lu ZL, Xu ZM, Kou WR, Zhao SP. Advance in basic and clinical research of Xuezhikang Capsule. Chin J Integr Med 2006;12:85-93.
17. Phillipson BE, Rothrock DW, Connor WE, et al. Reduction of plasma lipids, lipoproteins, and apoproteins by dietary fish oils in patients with hypertriglyceridemia. NEJM 1985;312: 1210-1216. (Pubitemid 15009154)
18. Dai Y, Yan HH, Wang F. Effects of a-linolenic acid and clinolenic acid on the blood-lipid levels in hyperlipidemia people. Prog Mod Biomed (Chin) 2009;9:4492-4495.
19. Griffin MD, Sanders TA, Davies IG, et al. Effects of altering the ratio of dietary n-6 to n-3 fatty acids on insulin sensitivity, lipoprotein size, and postprandial lipemia in men and postmenopausal women aged 45-70 y: The OPTILIP Study. Am J Clin Nutr 2006;84:1290-1298. (Pubitemid 44912809)
20. Sadovsky R, Kris-Etherton P. Prescription omega-3-acid ethyl esters for the treatment of very high triglycerides. Postgrad Med 2009;121:145-153.
21. Barter P, Ginsberg HN. Effectiveness of combined statin plus omega-3 fatty acid therapy for mixed dyslipidemia. Am JCardiol 2008;102:1040-1045.
22. Jahromi MAF, Ray AB. Antihyperlipidemic effect of flavonoids from Pterocarpus marsupium. J Nat Prod 1993;56: 989-999.
23. Zhao SP, Liu L, Cheng YC, et al. Xuezhikang, an extract of cholestin, protects endothelial function through anti-inflammatory and lipid-lowering mechanisms in patients with coronary heart disease. Circulation 2004;110:915-920. (Pubitemid 39128616)
24. Lu L, Zhou JZ, Wang L, Zhang TX. Effects of Xuezhikang and pravastatin on circulating endothelial progenitor cells in patients with essential hypertension. Chin J Integr Med 2009; 15:266-271.
25. Fan XF, Deng YQ, Ye L, et al. Effect of Xuezhikang capsule on serum tumor necrosis factor-alpha and interleukin-6 in patients with nonalcoholic fatty liver disease and hyperlipidemia. Chin J Integr Med 2010;16:119-123.
26. Liu JD, Liu ZQ, Cui LQ, et al. Short-term application of Xuezhikang on plasma levels of C-reactive protein in perioperative percutaneous coronary intervention. Chin J Cardiol (Chin) 2006;34:406.
27. Yao QH, Cui CC, Wang JK. Effect of xuezhikang on blood lipids, serum oxidized low density lipoprotein, C-reactive protein and fibrinogen in patients with unstable angina pectoris. Chin J Integr Tradit West Med (Chin) 2003;23: 750-752.
28. Huang J, Wang MH, Peng XP, et al. Effects of Xuezhikang on serum levels of high sensitive-C reactive protein, matrix metalloproteinase-9 and lipoprotein in patients with cute coronary syndrome. Chin J Integr Tradit West Med (Chin) 2006;26:221-223.
29. Jian J, Hao X, Deng C, et al. The effects of Xuezhikang on serum lipid profile, thromboxane A2 and prostacyclin in patients with hyperlipidemia. Chin J Intern Med (Chin) 1999;38:517-519.
30. Laufs U, La Fata V, Plutzky J, Liao JK. Upregulation of endothelial nitric oxide synthase by HMG CoA reductase inhibitors. Circulation 1998;97:1129-1135. (Pubitemid 28152885)
31. Arntzenius AC, Kromhout D, Barth JD, et al. Diet, lipoproteins, and the progression of coronary atherosclerosis: The Leiden Intervention Trial. NEJM 1985;312:805-811. (Pubitemid 15104773)
32. Carpentier YA, Portois L, Malaisse WJ. n-3 fatty acids and the metabolic syndrome. Am J Clin Nutr 2006;83(6 suppl): 1499S-1504S. (Pubitemid 44713091)
33. He K, Liu K, Daviglus ML, et al. Associations of dietary long-chain n-3 polyunsaturated fatty acids and fish with biomarkers of inflammation and endothelial ctivation (from the Multi-Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol 2009;103:1238-1243.
34. Vedin I, Cederholm T, Freund Levi Y, et al. Effects of docosahexaenoic acid-rich n-3 fatty acid supplementation on cytokine release from blood mononuclear leukocytes: The OmegAD study. Am J Clin Nutr 2008;87:1616-1622 (Pubitemid 351872622)
35. He K, Liu K, Daviglus ML, et al. Intakes of long-chain n-3 polyunsaturated fatty acids and fish in relation to measurements of subclinical atherosclerosis. Am J Clin Nutr 2008;88:1111-1118.
36. Hilpert KF, West SG, Kris-Etherton PM, et al. Postprandial effect of n-3 polyunsaturated fatty acids on apolipoprotein B-containing lipoproteins and vascular reactivity in type 2 diabetes. Am J Clin Nutr 2007;85:369-376. (Pubitemid 46220936)
37. Zhao G, Etherton TD, Martin KR, et al. Dietary alphalinolenic acid inhibits proinflammatory cytokine production by peripheral blood mononuclear cells in hypercholesterolemic subjects. Am J Clin Nutr 2007;85:385-391. (Pubitemid 46220938)
38. Djoussé L, Folsom AR, Province MA, et al. Dietary linolenic acid and carotid atherosclerosis: The National Heart, Lung, and Blood Institute Family Heart Study. Am J Clin Nutr 2003;77:819-825.
39. Bouwens M, van de Rest O, Dellschaft N, et al. Fish-oil supplementation induces antiinflammatory gene expression profiles in human blood mononuclear cells. Am J Clin Nutr 2009;90:415-424.
40. Xiao LZ, Xu X, Lai SY, et al. Protective effects of soy isoflavones on atherosclerosis in ovariectomized rabbits and possibly involved mechanism. South China J Cardiovasc Dis (Chin) 2004;10:144-145.
41. Loke WM, Hodgson JM, Proudfoot JM, et al. Pure dietary flavonoids quercetin and (-)-epicatechin augment nitric oxide products and reduce endothelin-1 acutely in healthy men. Am J Clin Nutr 2008;88:1018-1025.
42. Fuchs D, Vafeiadou K, Hall WL, Daniel H, Williams CM, Schroot JH, et al. Proteomic biomarkers of peripheral blood mononuclear cells obtained from postmenopausal women undergoing an intervention with soy isoflavones. Am J Clin Nutr 2007;86:1369-1375. (Pubitemid 350126240)
43. Nasca MM, Zhou JR, Welty FK. Effect of soy nuts on adhesion molecules and markers of inflammation in hypertensive and normotensive postmenopausal women. Am JCardiol 2008;102:84-86.
44. Li JJ, Zhang ZY. The progress of anti-atherosclerosis of magnesium. Stud Trace Elem Health (Chin) 2003;20:49-51.
45. Schnabel R, Lubos E, Messow CM, et al. Selenium supplementation improves antioxidant capacity in vitro and in vivo in patients with coronary artery disease: The Selenium Therapy in Coronary Artery disease Patients (SETCAP) Study. Am Heart J 2008;156:1201.e1-11.
46. Yun BS, Cho Y, Lee IK, et al. Sterins A and B, new antioxidative compounds from Stereum hirsutum. J Antibiot (Tokyo) 2002;55:208-210. (Pubitemid 34285460)
47. Yao ZL, Zhu CC, Wan XQ. Clinical research of Xuezhikang joint sport in treatment of steatohepatitis who had symptoms. Chin J Modern Med (Chin) 2006;16:253-256.
48. Hong XZ, Li LD, Wu LM. Effects of fenofibrate and xuezhikang on high-fat diet-induced non-alcoholic fatty liver disease. Clin Exp Pharmacol Physiol 2007;34:27-35. (Pubitemid 46069582)
49. China Consensus Group on the Clinical Application of Xuezhikang Capsule. China consensus on the clinical application of Xuezhikang capsule. Chin J Intern Med (Chin) 2009;48:171-174.
50. Tipoe GL, Leung TM, Liong EC, et al. Epigallocatechin-3- gallate (EGCG) reduces liver inflammation, oxidative stress and fibrosis in carbon tetrachloride (CCl4)-induced liver injury in mice. Toxicology 2010;273:45-52.
51. Kim MH, Kang KS, Lee YS. The inhibitory effect of genistein on hepatic steatosis is linked to visceral adipocyte metabolism in mice with diet-induced non-alcoholic fatty liver disease. Br J Nutr 2010;104:1333-1342.
52. Aaseth J, Thomassen Y, Alexander J, Norheim G. Decreased serum selenium in alcoholic cirrhosis. NEJM 1980;303:944-945. (Pubitemid 10021202)
53. Hong MY, Seeram NP, Zhang Y, Heber D. Anticancer effects of Chinese red yeast rice versus monacolin K alone on colon cancer cells. J Nutr Biochem 2008;19:448-458. (Pubitemid 351783405)
54. Hardman WE. (N-3) fatty acids and cancer therapy. J Nutr 2004;134:3427S.
55. Jiang WG, Bryce RP, Horrobin DF, Mansel RE. Regulation of tight junction permeability and occludin expression by polyunsaturated fatty acids. Biochem Biophys Res Commun 1998;244:414-420. (Pubitemid 28414097)
56. Mehta SP, Boddy AP, Cook J, et al. Effect of n-3 polyunsaturated fatty acids on Barrett's epithelium in the human lower esophagus. Am J Clin Nutr 2008;87:949-956. (Pubitemid 351549240)
57. Zhu RX, Zhang SL, Jin YS. Recent advances in the study on antitumor effects of flavonoids. Drugs Clinic 2010;25: 5-10.
58. Zeng S, Yang Y, Guo QL. Mechanism of flavonoids-induced apoptosis in cancer cells and related experimental researches: A review. Prog Pharm Sci (Chin) 2009;33:402-407.
59. Shen DL, Li B, Li JG, et al. Anticancer mechanism of selenium: Recent progress. Chin J Cancer Biother (Chin) 2008; 15:598-600.
60. Subbiah MT. Dietary plant sterols: Current status in human and animal sterol metabolism. Am J Clin Nutr 1973;26: 219-225.
61. Kahols K, Kangas L, Hiltunen R. Ergosterol peroxide, an active compound from Inonutus radiatus. Planta Med 1989;55:389-390.
62. Dai XH, Xue XY, Wang L, et al. The effects of Xuezhikang on insulin sensitivity for patients with hypertension complicated with dyslipidemia. Chin J Cardiol (Chin) 2000;20: 692-693.
63. Carpentier YA, Portois L, Malaisse WJ. N-3 fatty acids and the metabolic syndrome. Am J Clin Nutr 2006;83(6 suppl): 1499S-1504S. (Pubitemid 44713091)
64. Stirban A, Nandrean S, Götting C, et al. Effects of n-3 fatty acids on macro- and microvascular function in subjects with type 2 diabetes mellitus. Am J Clin Nutr 2010;91: 808-813.
65. Liu ZM, Chen YM, Ho SC, et al. Effects of soy protein and isoflavones on glycemic control and insulin sensitivity: A 6-mo double-blind, randomized, placebo-controlled trial in postmenopausal Chinese women with prediabetes or untreated early diabetes. Am J Clin Nutr 2010;91:1394-401.
66. Barbagallo M, Dominguez LJ, Resnick LM. Magnesium metabolism in hypertension and type 2 diabetes mellitus. Am J Ther 2007;14:375-385. (Pubitemid 47220849)
67. Kim DJ, Xun P, Liu K, et al. Magnesium intake in relation to systemic inflammation, insulin resistance, and the incidence of diabetes. Diabetes Care 2010;33:2604-2610.
68. Zhang M. Hypoglycemic effect of selenium-enriched compound SOD green tea in diabetic rats. Parenter Enteral Nutr (Chin) 2009;16:109.
69. Wang JM, Lv XY. Effects of Xuezhikang on left ventricular and remodeling for patients with hypertension. Clin Focus (Chin) 2000;15:645-646.
70. Gong C, Huang SL, Huang JF, et al. Effects of combined therapy of Xuezhikang Capsule and Valsartan on hypertensive left ventricular hypertrophy and heart rate turbulence. Chin J Integr Med 2010;16:114-118.
71. Ye P, Wu CE, Sheng L, Li H. Potential protective effect of long-term therapy with Xuezhikang on left ventricular diastolic function in patients with essential hypertension. J Altern Complement Med 2009;15: 719-725.
72. Ramasubbu K, Mann DL. The emerging role of statins in the treatment of heart failure. J Am Coll Cardiol 2006;47: 342-344. (Pubitemid 43063252)
73. Zhou FY, Zhang J, Song T, et al. Effects of xuezhikang and simvastatin on cerebral ischemia-reperfusion injury in rat. China J Chin Mater Med (Chin) 2006;31:1447-1450.
74. Tian F, Qi XX, Zheng ZH. a-linolenic acid on learning and memory function and hippocampal neurons of rats. Chin J Geriatrics (Chin) 2009;29:664-666.
75. Féart C, Peuchant E, Letenneur L, et al. Plasma eicosapentaenoic acid is inversely associated with severity of depressive symptomatology in the elderly: Data from the Bordeaux sample of the Three-City Study. Am J Clin Nutr 2008;87:1156-1162. (Pubitemid 351679753)
76. Pan YH, Zhao QJ, Feng HL, et al. c-Hydroxybutyric acid on focal cerebral ischemia-reperfusion injury. Chin J Neurol (Chin) 2001;34:319.
77. Tymianski M, Tator CH. Normal and abnormal calcium homeostasis in neuron: A basis for the pathophysiology of traumatic and ischemic CNS injury. Neurosurgery 1996;38: 1176-1195. (Pubitemid 26162765)
78. Cao ZX, Liao PY. Treatment of Xuezhikang on nephritic syndrome for children in hyperlipidemia with 30 cases. Chin J Cardiol (Chin) 2007;27:855-856.
79. Liu ZX, Lin Z, Wu YX, et al. Effects of Xuezhikang on microalbuminuria in patients with youth obesity. World J Integr Tradit West Med (Chin) 2007;12:719-721.
80. Patel S, Mason RM, Suzuki J, et al. Inhibitory effect of statins on renal epithelial-to-mesenchymal transition. Am J Nephrol 2006;26:381-387. (Pubitemid 44394157)
81. Qian JL, Zhang MF. Progress of n-3 polyunsaturated fatty acids on chronic kidney disease. Chin J Integr Tradit West Nephrol (Chin) 2009;1095-1097.
82. Wang J, Liang Y, Zhang YC, et al. Experimental study of alinolenic acid inhibitory effect on calcium oxalate crystallization in rats. Chin J Urol (Chin) 2004;25:163-165.
83. Lu L, Zhou JZ, Wang L, Zhang TX. Effects of Xuezhikang and pravastatin on circulating endothelial progenitor cells in patients with essential hypertension. Chin J Integr Med 2009;15:266-271.
84. Wong RW, Rabie B. Chinese red yeast rice (Monascus purpureus- fermented rice) promotes bone formation. Chin Med 2008;3:4.
85. Marini H, Bitto A, Altavilla D, et al. Breast safety and efficacy of genistein aglycone for postmenopausal bone loss: Afollow-up study. J Clin Endocrinol Metab 2008;93:4787-4796.
86. Mundy GR. Nutritional modulators of bone remodeling during aging. Am J Clin Nutr 2006;83:427S-430S. (Pubitemid 44713213)
87. Lauretani F, Semba RD, Bandinelli S, et al. Association of low plasma selenium concentrations with poor muscle strength in older community-dwelling adults: The In- CHIANTI Study. Am J Clin Nutr 2007;86:347-352. (Pubitemid 47256917)
88. Virtanen JK, Mursu J, Voutilainen S, Tuomainen TP. Serum long-chain n-3 polyunsaturated fatty acids and risk of hospital diagnosis of atrial fibrillation in men. Circulation 2009;120:2315-2321.
89. Wald NJ, Wald DS. The polypill concept. Heart 2010;96:1-4.