Soluble fiber improves multiple CV risk markers in hypercholesterolemia
MedWire News: Daily consumption of soluble fiber improves a broad range of cardiometabolic parameters in people with hypercholesterolemia, a randomized trial has demonstrated.
The study authors propose that Plantago ovate-derived “Po-husk” could be a useful adjunctive therapy in people with multiple risk factors for cardiovascular disease, such as those with the metabolic syndrome.
A multinational research team led by Rosa Solà (Hospital Universitari Sant Joan, Reus, Spain) evaluated the impact of Po-husk in middle-aged patients with mild-to-moderate hypercholesterolemia.
In all, 126 patients were randomly assigned to take Po-husk 14 g/day and 128 were assigned to take a microcrystalline-cellulose placebo, alongside a diet low in saturated fat. If blood lipids remained above target after 8 weeks, simvastatin 20 mg/day was added.
Po-husk is manufactured as 5-g sachets of orange-flavored powder containing 70% fiber, which are dissolved in 200 ml of water. A dose of 14 g/day is met by taking four sachets daily: one before breakfast, one before lunch, and two before the evening meal.
After 8 weeks, participants taking Po-husk showed a range of significant changes versus placebo. These included 6% reductions in both low-density lipoprotein (LDL) cholesterol and total cholesterol, a 21.6% fall in triglycerides, a 6.7% fall in apolipoprotein (apo)B-100, a 6.82 U/l fall in oxidized LDL, a 4.68 pmol/l fall in insulin, and a 4.0 mmHg drop in systolic blood pressure.
Subgroup analysis revealed interactions between Po-husk and genotype, such that the effect on triglycerides was magnified in people carrying the rs1799768 variant in PAI-1 and in those with the rs1799883 variant in FABP-2.
The impact of adding simvastatin on LDL cholesterol levels was equivalent in both Po-husk and placebo groups, the authors remark.
Writing in the journal Atherosclerosis, the authors note that the use of Po-husk was associated with a greater likelihood of achieving LDL cholesterol targets, especially in people with the most elevated levels at baseline. They also say that Po-husk appeared to be well-tolerated.
“Thus, the candidate patients to receive Po-husk would be those who present a cluster of various cardiovascular disease risk factors, such as metabolic syndrome, especially if they have drug intolerances as well,” they conclude.
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By Joanna Lyford