Medical intervention to reduce the risk of atherosclerosis using lipid modulating medications has been a target for reducing
cardiovascular risk for over 40 years. Lipid lowering medications, HMG-CoA reductase inhibitors (Statin’s), and more recently
PCSK9 inhibitors (PCSK9i (protein convertase subtilisin/kexin type 9 inhibitors) are now and in the future will be the main stay
therapy for reducing Atherosclerosis. However, the uncertainty of statin induced myalgia and other bad publicity via the media and
internet reports has caused many patients to opt out of statin therapy. Berberine and is quinoline alkaloid has had several clinical
trials demonstrating potential in managing cardiovascular disease risk. Berberine is a safe and natural alternative for modulating
circulating lipids including LDL-C, however possible drug interactions, due to its effects on P450 enzymes, does indicate some
caution should be exercised.