Data are available from both controlled and uncontrolled studies that have investigated the effects of artichoke leaf extract in hyperlipemia. Most studies use Hepar SL forteĀ® or Valverde Artischoke bei Verdauungsbeschwerden (artichoke dry extract) containing 450 g of herbal extract as a coated tablet.

Data from five uncontrolled studies and case series suggests that artichoke leaf extract and cynarin have lipid-lowering effects and a possible role as adjunctive therapy in hyperlipidaemia (Ulbricht & Basch 2005).

A Cochrane systematic review that analysed the results of two controlled studies concluded that artichoke leaf extract appears to have a modest positive effect on the levels of total cholesterol and LDL; however, there is insufficient evidence to recommend it as a treatment option for hypercholesterolemia and trials with larger samples sizes are still required (Pittler et al 2002).

One of the studies was a randomised, placebo-controlled, double-blind, multicentre trial involving 143 subjects with total cholesterol levels >7.3 mmol/L (>280 g/dL) (Englisch et al 2000). A dose of 1800 mg artichoke leaf extract was administered daily for 6 weeks. Active treatment resulted in 18.5% decrease in serum cholesterol compared with 8.6% for placebo, a result that was significant. No differences were observed between the groups for blood levels of either HDL or triglycerides. Although dietary habits were recorded, the food intake was not strictly controlled in the entire patient sample. The second randomised, placebo-controlled, double-blind study involved 44 healthy volunteers and compared 1920 mg artichoke extract daily to placebo over a 12-week treatment period. No significant effects on serum cholesterol levels were observed in this study; however, subgroup analyses suggested that patients with higher initial total cholesterol levels experienced a significant reduction in total cholesterol levels compared to placebo.

ESCOP approves the use of artichoke leaf as an adjunct to a low-fat diet in the treatment of mild to moderate hyperlipidaemia (ESCOP 2003).

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