What is the effect of Citrus bergamot on cholesterol levels and vascular outcomes?

From the Guidelines

Citrus bergamot extract is a promising supplement for improving cholesterol levels and vascular health, but its long-term safety and efficacy require further research, as noted in a 2020 expert opinion paper by the ESC Working Group on Cardiovascular Pharmacotherapy 1. When considering the use of citrus bergamot for cholesterol management and vascular outcomes, it is essential to understand its potential benefits and limitations.

• The available evidence suggests that bergamot may have lipid-lowering effects, similar to other nutraceuticals like red yeast rice, berberine, and plant sterols and stanols.
• However, as stated in the 2020 paper, there is still a need for more data to draw firm conclusions about the long-term safety and efficacy of these supplements 1.
• Some studies have shown that bergamot can reduce total cholesterol, LDL cholesterol, and triglycerides, while increasing HDL cholesterol, but these findings are not yet conclusive.
• The mechanisms behind bergamot's potential benefits are thought to involve the inhibition of HMG-CoA reductase and the activation of AMPK pathways, similar to statins.
• Despite the promising effects, citrus bergamot should be considered a supplement to standard treatments, rather than a replacement, and its use should be discussed with a healthcare provider, especially for patients taking medications like statins.
• Further research is needed to fully understand the effects of bergamot on cardiovascular health and to determine its potential role in the management of cholesterol levels and vascular outcomes, as highlighted in the 2020 expert opinion paper 1.

From the Research

Citrus Bergamot Research on Cholesterols and Vascular Outcomes

• Citrus bergamot has been studied for its potential benefits in reducing cholesterol levels and improving vascular outcomes 2, 3, 4.
• The flavonoids present in bergamot, such as brutieridin and melitidin, have been shown to have hypocholesterolemic and antioxidant activities 2, 3.
• Clinical trials have demonstrated that orally administered bergamot can reduce total cholesterol and low-density lipoprotein (LDL) cholesterol levels in patients with hypercholesterolemia 3, 5.
• The mechanism of action of bergamot in lowering cholesterol levels is thought to involve the inhibition of cholesterol synthesis and absorption, rather than the inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A (HMGCR) reductase, which is the target of statins 4.
• Bergamot has also been shown to have anti-inflammatory and anti-oxidative effects, which may contribute to its potential benefits in reducing cardiovascular morbidity 5.
• The efficacy of bergamot in reducing cholesterol levels and improving vascular outcomes has been demonstrated in both human and animal studies, with oral doses of 150-1000 mg/day of flavonoids administered for 30-180 days showing positive effects 3, 5.

Key Findings

• Bergamot flavonoids have been shown to decrease total and free cholesterol levels in HepG2 cells 4.
• Bergamot extract and its principal components have been shown to regulate cholesterol levels in HepG2 and Caco-2 cells 4.
• Bergamot has been shown to reduce blood diastolic and systolic pressure, and may have a significant effect on improving mental conditions 5.
• The use of bergamot in combination with statins may enhance lipid-lowering efficacy, although more research is needed to confirm this 6.