Mechanisms
Natural compounds like l-carnitine, coenzyme Q10 and xuezhikang emerge as Lp(a)-lowering options, a review of dietary agents (J Cell Physiol 2019)
Original title: Dietary natural products as emerging lipoprotein(a)-lowering agents
This review by Momtazi-Borojeni, Katsiki, Pirro, Banach, Rasadi and Sahebkar surveys dietary natural products as emerging Lp(a)-lowering agents. Niacin has traditionally been used to lower elevated Lp(a), but its efficacy for improving cardiovascular outcomes has been seriously questioned by recent clinical trials, and other available drugs reduce Lp(a) only modestly without a specific Lp(a)-lowering indication. Preclinical and clinical studies, along with meta-analyses, show that l-carnitine, coenzyme Q10, and xuezhikang significantly decrease Lp(a) levels in patients with elevated Lp(a), while pectin, Ginkgo biloba, flaxseed, red wine, resveratrol and curcuminoids reduce Lp(a) to a lesser degree. The authors conclude these natural products may represent promising therapeutic agents for lowering Lp(a).
Original abstract
Elevated plasma lipoprotein(a) (Lp(a)) levels are associated with an increased risk of cardiovascular disease (CVD). Hitherto, niacin has been the drug of choice to reduce elevated Lp(a) levels in hyperlipidemic patients but its efficacy in reducing CVD outcomes has been seriously questioned by recent clinical trials. Additional drugs may reduce to some extent plasma Lp(a) levels but the lack of a specific therapeutic indication for Lp(a)-lowering limits profoundly reduce their use. An attractive therapeutic option is natural products. In several preclinical and clinical studies as well as meta-analyses, natural products, including l-carnitine, coenzyme Q 10 , and xuezhikang were shown to significantly decrease Lp(a) levels in patients with Lp(a) hyperlipoproteinemia. Other natural products, such as pectin, Ginkgo biloba, flaxseed, red wine, resveratrol and curcuminoids can also reduce elevated Lp(a) concentrations but to a lesser degree. In conclusion, aforementioned natural products may represent promising therapeutic agents for Lp(a) lowering.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.