POLICOSANOL IS BETTER THAN CHOLESTEROL-LOWERING DRUGS

By Dr. Joseph A. Debé

Pharmaceutical companies have spent hundreds of millions of dollars to develop drugs to help lower blood cholesterol levels. To synthesize a compound that lowers serum cholesterol, improves vascular health in other ways, and is virtually free of side effects would be a dream come true for a research chemist. Such a compound exists in nature. It is called policosanol and it is derived from honeybee wax and sugarcane wax!

Policosanol has been extensively researched in animals and humans. The influence it has on cardiovascular health is nothing short of amazing. Policosanol is the subject of a review article in the current (February 2002) edition of American Heart Journal. As stated in this article, “At doses of 10 to 20 mg per day, policosanol lowers total cholesterol by 17% to 21% and low-density lipoprotein (LDL) by 21% to 29% and raises high-density lipoprotein cholesterol by 8% to 15%... At dosages of up to 20 mg per day, policosanol is safe and well tolerated, as studies of greater than 3 years of therapy indicate.”

Policosanol has consistently produce positive results in testing on healthy subjects and people with high cholesterol and various types of vascular disease. Policosanol has proven beneficial in all studies I have reviewed, including those involving people with genetically influenced type II hypercholesterolemia (high blood cholesterol). It has also improved cholesterol levels in people with non-insulin dependent diabetes mellitus.

In a study of patients with coronary heart disease, 12 received policosanol at 1 mg twice daily and 11 received a placebo. After 14 months, patients were evaluated with rest and stress electrocardiogram and serum lipid profiles. Five patients in the policosanol group showed signs of improvement in their coronary heart disease while no one in the placebo group improved.

The outcome of a study comparing policosanol with placebo in 437 people with type II hypercholsterolemia and additional coronary risk factors is representative of all similar studies I have reviewed. Subjects were randomly assigned to receive placebo or policosanol for 24 weeks. The policosanol group was given 5 mg once a day for the first twelve weeks then 10 mg per day for the last twelve weeks. Policosanol (5 and 10 mg/day) reduced total cholesterol (13.0 and 17.4%, respectively), LDL (“bad”) cholesterol (18.2% and 25.6%), and raised HDL (“good”) cholesterol (15.5% and 28.4%). Only the 10 mg dose lowered triglycerides (5.2%). Policosanol was well tolerated with no serious side effects reported. Ten patients in the placebo group had serious adverse events, including two cardiovascular-related deaths. Again and again, studies using policosanol show it to improve lipid profiles. The other consistent finding is more interesting. There are fewer side effects (including serious adverse vascular events) reported with policosanol than with placebo. This finding has two important implications. First, policosanol is a well-tolerated and safe compound. This conclusion is supported by animal research that has found no adverse effects from policosanol given at the equivalent of hundreds of times the dosage used in humans. Secondly, while those receiving placebo have progression of their vascular disease, people taking policosanol have improvement of vascular health.

A double-blind study published in 2001 compared policosanol with placebo in 56 patients with intermittent claudication. Intermittent claudication is a condition of vascular disease in the legs, which causes impaired ability to walk any significant distance. The subjects received either placebo or 10 mg of policosanol twice daily for two years. At the beginning and at the end of the study, walking distance was evaluated. Twenty-one (75%) of the subjects receiving policosanol had improvement of walking distance of  greater than 50 %  compared with only 5 people in the placebo group. There were no serious adverse events in the policosanol group, while there were 10 in the placebo group (including 8 vascular events).

Policosanol produces multiple beneficial effects on vascular health in addition to improving cholesterol levels. It reduces the tendency of blood platelets to clump together. It lowers the peroxidation of LDL cholesterol. Whereas intact LDL cholesterol appears to be relatively innocuous, LDL that has been damaged by free radicals stimulates atherosclerosis. Policosanol also reduces growth of smooth muscle cells within arterial walls. The end result of these actions of policosanol is that it protects against development of atherosclerosis. This has been demonstrated in animal studies.

Studies have compared policosanol and aspirin for their ability to inhibit platelet aggregation. Policosanol at 20 mg per day was found to be as effective as 100 mg of aspirin, with fewer side effects. A study on 45 patients with coronary heart disease found the addition of aspirin to enhance the ability of policosanol to improve blood flow to the heart and reduce angina (chest pain).

Several studies have been done to compare policosanol with cholesterol-lowering drugs. In one representative double-blind study, older patients with type II hypercholesterolemia received either 10 mg of policosanol or the drug pravastatin for 8 weeks. The results of policosanol and pravastatin on altering lipid profiles were as follows:  total cholesterol reduced 13.9% and 11.8%, respectively, LDL cholesterol lowered 19.3% and 15.6%, and reduction in the total cholesterol/HDL cholesterol ratio by 24.4% and 15.7%, respectively. Whereas pravastatin had no effect on levels of triglycerides or HDL cholesterol, policosanol lowered triglycerides by 14.1% and raised HDL by 18.4%. Additionally, policosanol was more effective than pravaststin at reducing platelet aggregation. Side effects were seen with pravastatin but not with policosanol.

An animal study compared policosanol and another cholesterol-lowering drug, lovastatin. The ability of these compounds to inhibit smooth muscle cell proliferation in carotid arteries was examined. Smooth muscle proliferation is part of the atherosclerotic process. Policosanol was found to be more effective.

Studies on policosanol have found 20 mg per day to be just about as effective as 40 mg per day in improving cholesterol profiles. The 40 mg dose however, does produce additional anti-platelet aggregation effect. The policosanol product I recommend is called Cholarest. It uses rice bran oil and soy lecithin to enhance the bioavailability of the policosanol. Whereas other products have a dissolution of about 65%, Cholarest has a dissolution of 95%. This equates to a 50% higher dosage, at a lower cost than other brands.

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