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Recommended by international guidelines

Plant stanol ester is recommended by international guidelines

International guidelines consistently recommend the use of plant stanol ester as part of a cholesterol-lowering diet. The 2019 joint European Atherosclerosis Society (EAS)/European Society of Cardiology (ESC) guidelines define the target groups for plant stanol ester use as:1

  • Individuals who have elevated serum cholesterol levels and are at low or intermediate global cardiovascular risk but who do not need cholesterol-lowering medication
  • High- and very high-risk patients, such as patients with diabetes, who fail to achieve low-density lipoprotein cholesterol (LDL-C) targets on statins alone, or are statin intolerant
  • Adults and children (from the age of 6 years) with familial hypercholesterolaemia
Plant stanol ester: Mechanism of action

National and international cardiovascular guidelines consistently recommend plant stanol ester

The role of plant stanol ester as part of a cholesterol-lowering diet has been acknowledged in prevention and treatment guidelines and position papers issued by international bodies such as the European Atherosclerosis Society,1 the European Society of Cardiology,1,2 the International Atherosclerosis Society3 and the World Health Organization.4

The guidelines that recommend plant stanol ester as part of a cholesterol-lowering diet can be classified under these broader patient sub-groups.

Primordial and primary prevention

ESC/EAS: The Task Force for the management of dyslipidaemias of the European Society of Cardiology and the European Atherosclerosis Society: Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019).1

ACC: 2017 focused update of the 2016 ACC expert consensus decision pathway on the role of non-statin therapies for LDL-cholesterol lowering in the management of atherosclerotic cardiovascular disease risk: a report of the American College of Cardiology Task Force on expert decision pathways (2017).5

ESC/EACPR: 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (2016).2

NLA: National Lipid Association recommendations for patient-centered management of dyslipidemia (2015).6

JBS: Joint British Societies’ consensus recommendations for the prevention of cardiovascular disease (2014).7

IAS: An International Atherosclerosis Society Position Paper: Global recommendations for the management of dyslipidemia (2014).3

WHO/FAO: Report of a Joint World Health Organization/Food and Agriculture Organization Expert Consultation: Diet, nutrition, and the prevention of chronic diseases (2003).4


NHLBI: National Heart, Lung, and Blood Institute: Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report (2011).8

AAP: American Academy of Pediatrics: Lipid Screening and Cardiovascular Health in Childhood (2008).9


ADA: American Diabetes Association:

  • Standards of Medical Care in Diabetes: Cardiovascular Disease and Risk Management (2019)10
  • Nutrition therapy recommendations for the management of adults with diabetes. A position statement of the American Diabetes Association (2013)11

secondary prevention

ADA/ACC: Lipoprotein Management in Patients with Cardiometabolic Risk: Consensus Conference Report from the American Diabetes Association and the American College of Cardiology Foundation (2008).12

Familial hypercholesterolaemia

EAS: European Atherosclerosis Society:

  • Familial hypercholesterolaemia in children and adolescents: gaining decades of life by optimizing detection and treatment (2015)13
  • Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease. Consensus statement of the European Atherosclerosis Society (2013)14

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