Chapter 7 A New Perspective on the Development of Cholesterol-Lowering Products

1. Introduction

1.1. Health impact of cardiovascular disease (CVD)

2. Risk factors of CVD

2.1. Unmodifiable risk factors

2.1.1. Ageing

2.1.2. Gender

2.1.3. Heredity (including race)

2.2. Modifiable risk factors

2.2.1. Obesity

2.2.2. High blood cholesterol

2.2.3. High blood pressure

2.2.4. Physical inactivity

2.2.5. Diabetes mellitus

2.2.6. Tobacco smoke

3. Atherosclerosis and CVD

4. Cholesterol homeostasis

5. Hyperlipidemia and causes

6. Metabolic pathways involved in cholesterol homeostasis

6.1. Biosynthesis

6.2. Absorption

6.3. Transport

6.4. Excretion of cholesterol

7. Regulation of specific pathways and its influence on cholesterol homeostasis

7.1. LDL receptor-mediated cholesterol clearance

7.2. Regulation of cholesterol biosynthesis

7.3. Regulation of cholesterol absorption and secretion

7.4. Regulation of cholesterol transport

7.5. Excretion of cholesterol

8. Cholesterol-lowering drugs

8.1. Statins – Benefits versus side effects

8.2. Ezetimibe – Benefits and side effects

8.3. Niacin (Nicotinic acid)

8.4. Bile acid sequestrant

8.5. Fibrates

9. Cholesterol-lowering natural products

9.1. Plant sterols/ stanols

9.2. Soy products

9.3. Dietary fibre

9.4. Flaxseed lignans

9.5. Polyunsaturated fatty acids and omega-3 fatty acids

9.6. Olive oil

9.7. Green tea products

10. New perspectives on the development of natural cholesterol-lowering products

10.1. Current status in the development of cholesterol-lowering products

10.1.1. Lowering LDL cholesterol

10.1.2. Increasing HDL levels

10.1.3. CETP inhibition

10.1.4. Inhibition of cannabinoid receptors

10.1.5. Nuclear receptor modifiers

10.1.6. Acyl-coenzyme A: Cholesterol acyltransferas (ACAT) inhibitors

10.2. Future perspectives of cholesterol-lowering products and their potential impact on CVD

10.2.1. Identification of new molecular targets

10.2.2. Application of gene silencing technology

10.2.3. Development of target-specific inhibitors or enhancers

11. Conclusions

Author details

References