Policosanols act by decreasing the endogenous synthesis of cholesterol and triglycerides. More specifically, the cholesterol-lowering effect is attributable to the hepatic enzyme that regulates the synthesis of cholesterol, 3-hydroxy-3-methylglutaryl-coenzyme A reductase.
Despite the potential benefits in countering high cholesterol, policosanols can be recommended at the moment by the doctor to patients with low cardiovascular risk; in fact, these substances are still the object of scientific research aimed at shedding light on their controversial validity.
, from which they are extracted and marketed without a prescription. From the chemical point of view, it is a mixture of linear long-chain aliphatic alcohols (octacosanol, tetracosanol, hexacosanol and others)..
The cholesterol-lowering properties of policosanols are evidenced by a conspicuous scientific production, even if, in this regard, there are conflicting results.
The ability of policosanols to reduce blood levels of total and LDL cholesterol, while increasing those of HDL, is supported by much research, largely sponsored by the same Cuban company that markets policosanols. This data should trigger a first alarm bell; the independence of research with respect to commercial interests is, in fact, a very important requirement for evaluating the reliability of a study. One of these, conducted in Germany in 2006, has shown that after 12 weeks of treatment there was no significant difference in plasma lipid levels between the various groups, treated, respectively, with placebo and with policosanols at different doses (even at doses significantly higher than the therapeutic ones). with what has been demonstrated so far. The same argument, of course, is also valid on the other front, because a company that produces statins or fibrates would have every interest in demonstrating that policosanols are less effective than conventional drugs.
Based on all these considerations, the Italian health bodies recommend a prudent approach, to be implemented by reserving policosanols only for patients with a low cardiovascular risk profile, as adjuvants for metabolic rebalancing in the presence of modest dyslipidemic forms (they can be used, for for example, with the aim of bringing slightly elevated cholesterol levels back to normal in a healthy individual).
Considering them and proposing them as an alternative to drugs with proven efficacy, such as statins, could in fact endanger the health of those who are more exposed to cardiovascular disease and need greater protection.
