Table 10: Approximate and cumulative LDL-cholesterol reduction achievable by dietary modification
|Ways to further lower cholesterol
||Approximate LDL-cholesterol reduction
|Doubling statin dose
|Adding plant sterol/Stanols
||7 - 10%
Table adapted from ESC/EAS Guidelines, 20111 and Gylling et al., 20142.
Plant sterols and stanols and Ezetimibe
Consumption of plant sterols and stanols and treatment with ezetimibe both reduce cholesterol absorption in the intestine, although the exact mechanisms of action differ2. Very limited data are currently available about the combined use of plant sterols and stanols and ezetimibe.
The results from one clinical study indicate that adding plant sterols on top of ezetimibe has no therapeutic
benefit over ezetimibe alone in hypercholesterolemic individuals16. On the other hand, a significant further reduction in intestinal cholesterol absorption has been shown in another study during administration of ezetimibe plus plant sterols (2 g/day) which resulted in an additional 7 % reduction in LDL-cholesterol compared to ezetimibe alone17.