Cardiovascular diseases (CVDs) are the main cause of mortality worldwide. Risk factors of CVD can be classified into modifiable (smoking, hypertension, diabetes, hypercholesterolemia) through lifestyle changes or taking drug therapy and not modifiable (age, ethnicity, sex and family history). Elevated total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) levels have a lead role in the development of coronary heart disease (CHD), while high levels of high-density lipoprotein-cholesterol (HDL-C) seem to have a protective role.

The current treatment for dyslipidemia consists of lifestyle modification or drug therapy even if not pharmacological treatment should be always considered in addition to lipid-lowering medications.

The use of lipid-lowering nutraceuticals alone or in association with drug therapy may be considered when the atherogenic cholesterol goal was not achieved.

These substances can be classified according to their mechanisms of action into natural inhibitors of intestinal cholesterol absorption, inhibitors of hepatic cholesterol synthesis and enhancers of the excretion of LDL-C. Nevertheless, many of them are characterized by mixed or unclear mechanisms of action.

The use of these nutraceuticals is suggested in individuals with borderline lipid profile levels or with drug intolerance, but cannot replace standard lipid-lowering treatment in patients at high, or very high CVD risk.

Nutraceuticals can also have vascular effects, including improvement in endothelial dysfunction and arterial stiffness, as well as antioxidative properties. Moreover, epidemiological and clinical studies reported that in patients intolerant of statins, many nutraceuticals with demonstrated hypolipidemic effect are well tolerated.

心血管疾病（CVD）是全世界死亡的主要原因。CVD的危险因素可通过改变生活方式或接受药物治疗分为可改变的（吸烟，高血压，糖尿病，高胆固醇血症），而不是可改变的（年龄，种族，性别和家族史）。总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）水平升高在冠心病（CHD）的发展中起主导作用，而高密度脂蛋白胆固醇（HDL-C）似乎高起到保护作用。

当前的血脂异常的治疗方法包括改变生活方式或药物治疗，即使除降低脂质的药物外，始终应考虑不进行药物治疗。

当未达到致动脉粥样硬化的胆固醇目标时，可考虑单独使用降脂保健食品或与药物治疗结合使用。

这些物质可根据其作用机理分为肠道胆固醇吸收的天然抑制剂，肝脏胆固醇合成的抑制剂和LDL-C排泄增强剂。然而，它们中的许多特征是混合的或不清楚的作用机理。

建议在具有临界脂质水平或药物耐受性差的患者中使用这些营养保健品，但不能替代具有较高或非常高CVD风险的患者的标准降脂治疗。

营养保健品还可以具有血管作用，包括改善内皮功能障碍和动脉僵硬度以及抗氧化特性。此外，流行病学和临床研究报告说，在他汀类药物不耐受的患者中，许多具有降血脂作用的保健品被很好地耐受。