Comparative analysis of the lipid-lowering efficacy of policosanol and xuezhikang respectively combined with ezetimibe versus pravastatin monotherapy on total cholesterol and low-density lipoprotein cholesterol in high-risk ASCVD populations
WANG He
ZHENG Ziqiang
JIANG Ping
LI Congcong
HAO Pengfei
Abstract：Objective To compare the lipid-lowering efficacy of policosanol combined with ezetimibe,Xuezhikang(red yeast rice)combined with ezetimibe,and moderate-intensity statin(pravastatin)monotherapy in a high-risk population with Atherosclerotic Cardiovascular Disease(ASCVD).The study evaluated the effects and safety of these three regimens on reducing Total Cholesterol(TC)and Low-Density Lipoprotein Cholesterol(LDL-C)levels,providing a reference for lipid management in primary care.Methods A prospective,randomized controlled trial(RCT)was conducted.A computer-generated random number table was used for allocation;the random sequence was generated by a statistician independent of the research team.Allocation concealment was achieved using sealed,opaque envelopes.Group assignment was sealed in envelopes beforehand and opened by a research assistant not involved in enrollment after patients completed baseline assessments and met inclusion criteria.Neither investigators nor participants were involved in the allocation process to avoid selection bias.124 ASCVD patients diagnosed in our outpatient department from 2023 to 2025 with hypertension,hypercholesterolemia,and classified as high-risk were enrolled and randomly divided into three groups:Group A(pravastatin monotherapy,40 mg∕day,n=41),Group B(policosanol 5 mg∕day+ezetimibe 10 mg∕day,n=43),and Group C(Xuezhikang 0.6 g twice daily+ezetimibe 10 mg∕day,n=40).Baseline characteristics were comparable(P>0.05).Efficacy indicators included:TC and LDL-C levels(mmol∕L)and their reductions from baseline,LDL-C target achievement rate(proportion of patients with post-treatment LDL-C<2.6 mmol∕L),and incidence of adverse reactions(including muscle pain,gastrointestinal reactions,abnormal liver∕kidney function,elevated creatine kinase).All patients received treatment alongside dietary control and moderate exercise,with follow-up lasting 8-12 weeks.Results Post-treatment TC levels were(4.30±0.30)mmol∕L,(4.27±0.28)mmol∕L,and(4.70±0.40)mmol∕L for Groups A,B,and C,respectively.LDL-C levels were(2.53±0.25)mmol∕L,(2.45±0.24)mmol∕L,and(2.59±0.30)mmol∕L,respectively.ANOVA with post-hoc testing(LSD method)showed that Group B had significantly lower TC levels than Group C(t=5.82,P<0.05),and significantly lower LDL-C levels than Group C(t=2.56,P<0.05).The difference between Group B and Group A was not statistically significant(P>0.05).LDL-C target achievement rates were 58.5%,62.8%,and 42.5%for Groups A,B,and C,respectively,with no statistically significant difference among groups(P=0.151).The adverse reaction rates were 24.4%,4.7%,and 10.0%for Groups A,B,and C,respectively,with a statistically significant difference observed(χ2=7.104,P<0.05).Conclusion The policosanol combined with ezetimibe group showed the greatest numerical reduction in LDL-C levels and the lowest adverse reaction rate.
Keywords：policosanolxuezhikangezetimibelow-density lipoprotein cholesterolatherosclerotic cardiovascular disease
Publication Date：2026-01-30
Online Publishing Date：2026-01-27(First online date of this platform, not the publication date of the document)
Pages：4( 69-72 )