Policosanol for Cholesterol: Does It Work for Seniors?

randomized-controlled-trial PMID: 12099160

Quick Summary: A study found that policosanol helped lower "bad" LDL cholesterol and raise "good" HDL cholesterol in older adults with high blood pressure and high cholesterol. It also seemed to reduce the risk of serious health problems.

What The Research Found

This research looked at how policosanol affected older people with high blood pressure and high cholesterol. The study showed that policosanol:

Significantly lowered LDL cholesterol (the "bad" kind) by about 20%.

Increased HDL cholesterol (the "good" kind) by about 13%.

Reduced the risk of serious health problems related to blood vessels.

Had fewer side effects compared to a placebo (a sugar pill).

Study Details

Who was studied: 589 older men and women with high blood pressure and high cholesterol, but no history of heart disease or stroke.

How long: The study lasted for 12 months.

What they took: Participants took either policosanol (5-10 mg daily) or a placebo pill.

What This Means For You

If you're an older adult with high blood pressure and high cholesterol, this study suggests that policosanol might help lower your cholesterol levels and improve your overall health. It could be a potential option, but it's important to talk to your doctor first.

Important Note: Policosanol is not FDA-approved for cholesterol treatment in the US.

Study Limitations

The study was done on a specific group of people, so the results might not be the same for everyone.

The study didn't mention who paid for the research, which can sometimes affect the results.

The study was done in a specific geographic region, so the results may not apply to other populations.

The study didn't monitor how well people followed the diet plan.

Key Findings

Policosanol significantly reduced LDL-C (20.5%, p < 0.00001), total cholesterol (15.4%), triglycerides (11.9%), and atherogenic ratios (LDL-C/HDL-C: 22.2%; TC/HDL-C: 20.1%) while increasing HDL-C (12.7%, p < 0.0001) over 12 months. It also reduced vascular serious adverse events (SAEs: 0.7% vs. 2.0% placebo, p < 0.05), all-cause SAEs (1.7% vs. 4.1%), and total adverse events (9.8% vs. 17.7%, p < 0.01). Three placebo recipients died from cardiac events (myocardial infarction/sudden arrest) versus none in the policosanol group. Systolic blood pressure decreased significantly versus baseline and placebo.

Study Design

This was a prospective, randomized, double-blind, placebo-controlled trial with parallel groups. It included 589 older adults (mean age not specified) with hypertension, type II hypercholesterolemia (total cholesterol >6.1 mmol/L), and no history of coronary or cerebrovascular disease. After a 6-week dietary run-in, participants were randomized to policosanol or placebo for 12 months.

Dosage & Administration

Participants initially received policosanol 5 mg/day or placebo once daily. Dosage was doubled to 10 mg/day at 6 months if total cholesterol remained >6.1 mmol/L. Administration was via oral tablets.

Results & Efficacy

Policosanol produced statistically significant lipid improvements: LDL-C ↓20.5% (p < 0.00001), total cholesterol ↓15.4%, HDL-C ↑12.7% (p < 0.0001), triglycerides ↓11.9%, LDL-C/HDL-C ratio ↓22.2%, and TC/HDL-C ratio ↓20.1%. Systolic blood pressure decreased significantly versus baseline and placebo (p values not specified for BP). Vascular SAEs occurred in 0.7% (2/294) of policosanol recipients versus 2.0% (6/295) in placebo (p < 0.05). Total adverse events were 9.8% (29/294) vs. 17.7% (52/295; p < 0.01).

Limitations

The study lacked disclosure of funding sources or potential conflicts of interest. Generalizability is limited to older hypertensive patients with hypercholesterolemia without prior cardiovascular disease, primarily from a single geographic region (implied Cuban cohort based on author affiliations). Diet adherence during the 12-month intervention was not monitored post-run-in. The trial was not powered to detect mortality differences, though zero policosanol deaths versus three placebo deaths were noted.

Clinical Relevance

For older adults with hypertension and high cholesterol but no prior heart disease, policosanol (5–10 mg/day) may offer clinically meaningful lipid improvements and reduced vascular events. The 20.5% LDL-C reduction approaches statin-level efficacy in this population, with a favorable safety profile (fewer adverse events than placebo). However, policosanol is not FDA-approved for cholesterol management, and these results require replication in diverse populations. Users should consult healthcare providers before substituting policosanol for prescribed lipid-lowering therapies.