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<p>Dyslipidaemia is a&#xa0;major risk factor for the development of atherosclerotic cardiovascular disease and affects up to 60% of the adult population in Western societies. In 2019, elevated LDL cholesterol levels accounted for 4.4&#xa0;million deaths globally—a&#xa0;46.7% increase compared to 1990. Statins remain the standard treatment and are capable of lowering LDL cholesterol levels by 20–55%, depending on the agent and dosage. However, up to 20% of patients report adverse effects, including musculoskeletal complaints (e.g. myalgia), gastrointestinal intolerance, or elevated liver enzymes, often leading to reduced adherence or discontinuation. In this context, red yeast rice (RYR), a&#xa0;traditional Chinese medicinal agent, has gained attention as part of integrative lipid management. RYR contains monacolin&#xa0;K, a&#xa0;naturally occurring HMG-CoA reductase inhibitor with pharmacological properties similar to synthetic statins. Its effects are complemented by isoflavones, phytosterols and saponins. In Traditional Chinese Medicine (TCM), RYR is used to transform phlegm, tonify “Spleen” (<i>o.&#xa0;lienalis</i>), and promote blood circulation—concepts related to metabolic dysregulation. Clinical evidence indicates that standardised RYR preparations can significantly reduce LDL cholesterol while being well tolerated. This clinical evidence is supported by the Chinese Coronary Secondary Prevention Study (CCSP) as well as by several meta-analyses demonstrating reductions in total cholesterol, LDL‑C, and triglycerides, accompanied by an increase in HDL‑C. Randomized controlled trials report LDL‑C reductions of 15–25% within 6–12&#xa0;weeks, without a&#xa0;significant increase in musculoskeletal adverse effects compared to placebo. RYR serves as a&#xa0;model for integrative medicine, combining traditional treatment principles with modern evidence-based practice in the management of dyslipidaemia.</p>

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Rot fermentierter Reis (hongqu) bei Dyslipidämie – eine integrative Betrachtung westlicher und traditionell chinesischer Therapieansätze

  • 期刊论文

  • 发表日期：

    2025年10月30日

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  • Kathrin Huntemann

摘要

Dyslipidaemia is a major risk factor for the development of atherosclerotic cardiovascular disease and affects up to 60% of the adult population in Western societies. In 2019, elevated LDL cholesterol levels accounted for 4.4 million deaths globally—a 46.7% increase compared to 1990. Statins remain the standard treatment and are capable of lowering LDL cholesterol levels by 20–55%, depending on the agent and dosage. However, up to 20% of patients report adverse effects, including musculoskeletal complaints (e.g. myalgia), gastrointestinal intolerance, or elevated liver enzymes, often leading to reduced adherence or discontinuation. In this context, red yeast rice (RYR), a traditional Chinese medicinal agent, has gained attention as part of integrative lipid management. RYR contains monacolin K, a naturally occurring HMG-CoA reductase inhibitor with pharmacological properties similar to synthetic statins. Its effects are complemented by isoflavones, phytosterols and saponins. In Traditional Chinese Medicine (TCM), RYR is used to transform phlegm, tonify “Spleen” (o. lienalis), and promote blood circulation—concepts related to metabolic dysregulation. Clinical evidence indicates that standardised RYR preparations can significantly reduce LDL cholesterol while being well tolerated. This clinical evidence is supported by the Chinese Coronary Secondary Prevention Study (CCSP) as well as by several meta-analyses demonstrating reductions in total cholesterol, LDL‑C, and triglycerides, accompanied by an increase in HDL‑C. Randomized controlled trials report LDL‑C reductions of 15–25% within 6–12 weeks, without a significant increase in musculoskeletal adverse effects compared to placebo. RYR serves as a model for integrative medicine, combining traditional treatment principles with modern evidence-based practice in the management of dyslipidaemia.