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Policosanol

Policosanol is a mixture of waxy alcohols, usually extracted from sugar cane, that is thought to influence how the body makes cholesterol and clears LDL from the blood. People mostly look at it for atherosclerosis, the artery-narrowing plaque buildup, and the evidence is limited: small trials found HDL, the "good" cholesterol, went up. Those studies were small, and one trial of 66 people found no clear difference in blood flow.

Sources: PMID 18217459

Best evidence
Grade C
Conditions studied
10
Outcomes
33
Graded outcomes
0071

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

10 conditions

Metabolic Health

Metabolic Health: outcomes studied for Policosanol
GradeOutcomeEffectSizeStudiesPeopleStudies list
LDL Oxidation

Small Improvement

Improves (the measure goes down)Small effect2 studies69 people

Studies that measured ldl oxidation

Low-density lipoprotein (LDL)Improves (the measure goes down)10 studies21 people

Studies that measured low-density lipoprotein (ldl)

High Cholesterol

High Cholesterol: outcomes studied for Policosanol
GradeOutcomeEffectSizeStudiesPeopleStudies list
Blood Pressure

Small Improvement

Improves (the measure goes down)Small effect589 people
Blood Flow

No effect

NoneNo effect1 study66 people

Studies that measured blood flow

Low-density lipoprotein (LDL)Improves (the measure goes down)10 studies1,100 people

Studies that measured low-density lipoprotein (ldl)

Total cholesterolImproves (the measure goes down)3 studies1,100 people

Studies that measured total cholesterol

LDL OxidationImproves (the measure goes down)2 studies21 people

Studies that measured ldl oxidation

High-density lipoprotein (HDL)Improves (the measure goes up)1,100 people
TriglyceridesImproves (the measure goes down)828 people

Dyslipidemia

  • High-density lipoprotein (HDL): improves
  • Low-density lipoprotein (LDL): improves
  • Total cholesterol: improves
Dyslipidemia: outcomes studied for Policosanol
GradeOutcomeEffectSizeStudiesPeopleStudies list
High-density lipoprotein (HDL)

Small Improvement

Improves (the measure goes up)Small effect64 people
Low-density lipoprotein (LDL)Improves (the measure goes down)10 studies85 people

Studies that measured low-density lipoprotein (ldl)

Total cholesterolImproves (the measure goes down)3 studies64 people

Studies that measured total cholesterol

LDL OxidationImproves (the measure goes down)2 studies69 people

Studies that measured ldl oxidation

TriglyceridesImproves (the measure goes down)64 people

High Blood Pressure

  • Blood Pressure: improves
  • Low-density lipoprotein (LDL): improves
  • Total cholesterol: improves
High Blood Pressure: outcomes studied for Policosanol
GradeOutcomeEffectSizeStudiesPeopleStudies list
Blood Pressure

Small Improvement

Improves (the measure goes down)Small effect589 people
Low-density lipoprotein (LDL)Improves (the measure goes down)10 studies678 people

Studies that measured low-density lipoprotein (ldl)

Total cholesterolImproves (the measure goes down)3 studies678 people

Studies that measured total cholesterol

High-density lipoprotein (HDL)Improves (the measure goes up)678 people
TriglyceridesImproves (the measure goes down)589 people

Atherosclerosis

  • High-density lipoprotein (HDL): improves
  • Low-density lipoprotein (LDL): improves
  • Total cholesterol: improves
Atherosclerosis: outcomes studied for Policosanol
GradeOutcomeEffectSizeStudiesPeopleStudies list
High-density lipoprotein (HDL)

Small Improvement

Improves (the measure goes up)Small effect179 people
Low-density lipoprotein (LDL)Improves (the measure goes down)10 studies179 people

Studies that measured low-density lipoprotein (ldl)

Total cholesterolImproves (the measure goes down)3 studies179 people

Studies that measured total cholesterol

TriglyceridesImproves (the measure goes down)179 people

Human Immunodeficiency Virus (HIV)

  • High-density lipoprotein (HDL): improves
  • Low-density lipoprotein (LDL): improves
  • Total cholesterol: improves
Human Immunodeficiency Virus (HIV): outcomes studied for Policosanol
GradeOutcomeEffectSizeStudiesPeopleStudies list
High-density lipoprotein (HDL)

Small Improvement

Improves (the measure goes up)Small effect54 people
Low-density lipoprotein (LDL)Improves (the measure goes down)10 studies54 people

Studies that measured low-density lipoprotein (ldl)

Total cholesterolImproves (the measure goes down)3 studies54 people

Studies that measured total cholesterol

Intermittent Claudication

  • High-density lipoprotein (HDL): improves
  • Low-density lipoprotein (LDL): improves
  • Total cholesterol: improves
Intermittent Claudication: outcomes studied for Policosanol
GradeOutcomeEffectSizeStudiesPeopleStudies list
High-density lipoprotein (HDL)

Small Improvement

Improves (the measure goes up)Small effect39 people
Low-density lipoprotein (LDL)Improves (the measure goes down)10 studies39 people

Studies that measured low-density lipoprotein (ldl)

Total cholesterolImproves (the measure goes down)3 studies39 people

Studies that measured total cholesterol

Intermittent Claudication SymptomsImproves (the measure goes down)1 study39 people

Studies that measured intermittent claudication symptoms

General Cardiovascular Health

  • Blood Flow: improves
General Cardiovascular Health: outcomes studied for Policosanol
GradeOutcomeEffectSizeStudiesPeopleStudies list
Blood FlowImproves (the measure goes up)1 study66 people

Studies that measured blood flow

Cognitive Improvement

  • Reaction Time: improves
Cognitive Improvement: outcomes studied for Policosanol
GradeOutcomeEffectSizeStudiesPeopleStudies list
Reaction TimeImproves (the measure goes up)1 study30 people

Studies that measured reaction time

Peripheral Arterial Disease

  • Intermittent Claudication Symptoms: improves
Peripheral Arterial Disease: outcomes studied for Policosanol
GradeOutcomeEffectSizeStudiesPeopleStudies list
Intermittent Claudication SymptomsImproves (the measure goes down)1 study56 people

Studies that measured intermittent claudication symptoms

Key findings

  • LDL OxidationMetabolic HealthImproves (the measure goes down)
  • Blood PressureHigh CholesterolImproves (the measure goes down)
  • High-density lipoprotein (HDL)DyslipidemiaImproves (the measure goes up)

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  • Grade C

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Studies cited

18 studies from PubMed

  1. Effect of sugar cane policosanol on lipid profile in primary hypercholesterolemiaPhytother Res · PMID 18167048
  2. Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal womenInt J Clin Pharmacol Res · PMID 11708573
  3. Lack of cholesterol-lowering efficacy of Cuban sugar cane policosanols in hypercholesterolemic personsAm J Clin Nutr · PMID 17093150
  4. Effects of policosanol on older patients with hypertension and type II hypercholesterolaemiaDrugs R D · PMID 12099160
  5. Comparative lipid-lowering effects of policosanol and atorvastatin: a randomized, parallel, double-blind, placebo-controlled trialAm Heart J · PMID 17070175
  6. Modified-policosanol does not reduce plasma lipoproteins in hyperlipidemic patients when used alone or in combination with statin therapyLipids · PMID 21739240
  7. Policosanol is ineffective in the treatment of hypercholesterolemia: a randomized controlled trialAm J Clin Nutr · PMID 17158441
  8. Effects of policosanol in older patients with type II hypercholesterolemia and high coronary riskJ Gerontol A Biol Sci Med Sci · PMID 11253161
  9. Rice policosanol does not have any effects on blood coagulation factors in hypercholesterolemic patientsColl Antropol · PMID 18217459
  10. Sugar cane policosanols do not reduce LDL oxidation in hypercholesterolemic individualsLipids · PMID 19337769
  11. Effects of policosanol (10 mg/d) versus aspirin (100 mg/d) in patients with intermittent claudication: a 10-week, randomized, comparative studyAngiology · PMID 18388038
  12. Changes in cholesterol kinetics following sugar cane policosanol supplementation: a randomized control trialLipids Health Dis · PMID 18447941
  13. Sugar cane policosanol failed to lower plasma cholesterol in primitive, diet-resistant hypercholesterolaemia: a double blind, controlled studyComplement Ther Med · PMID 18514906
  14. Effects of policosanol treatment on the susceptibility of low density lipoprotein (LDL) isolated from healthy volunteers to oxidative modification in vitroBr J Clin Pharmacol · PMID 10971310
  15. Policosanol for managing human immunodeficiency virus-related dyslipidemia in a medically underserved population: a randomized, controlled clinical trialAltern Ther Health Med · PMID 21717822
  16. Policosanol, reaction time and event-related potentialsNeuropsychobiology · PMID 10754431
  17. A long-term study of policosanol in the treatment of intermittent claudicationAngiology · PMID 11228084
  18. Effects of policosanol 20 versus 40 mg/day in the treatment of patients with type II hypercholesterolemia: a 6-month double-blind studyInt J Clin Pharmacol Res · PMID 11708574