1 3 Eur Food Res Technol (2014) 238:705–725 DOI 10.1007/s00217-014-2194-z REVIEW PAPER Natural lipid-lowering agents and their effects: an update Sultan Ayesh Mohammed Saghir · Vageesh Revadigar · Vikneswaran Murugaiyah Received: 27 August 2013 / Revised: 24 February 2014 / Accepted: 28 February 2014 / Published online: 3 April 2014 © Springer-Verlag Berlin Heidelberg 2014 FBG Fasting blood glucose FFA Free fatty acids HDL-C High-density lipoprotein cholesterol HFD High-fat diet HMG-Co A 3-Hydroxy-3-methylglutaryl coenzyme A h Hours I.P Intra peritoneal LCAT Plasma lecithin cholesterol acyl transferase LDL-C Low-density lipoprotein cholesterol LPL Lipoprotein lipase P.O Per oral STZ Streptozotocin TC Total cholesterol TG Triglycerides Introduction Hyperlipidemia is defined as an increase in the blood lipids levels, which include cholesterol and triglycerides. It con- tributes significantly to the manifestation and development of atherosclerosis and coronary heart diseases. Cardiovas- cular diseases, including atherosclerosis, are among the most common causes of mortality and morbidity world- wide [1, 2]. Globally, each year approximately 12 million people die due to cardiovascular diseases. Factors such as diet high in saturated fats and cholesterol, age, family his- tory, hypertension and life style are of great significance but high level of cholesterol, particularly LDL cholesterol is mainly responsible for the occurrence of coronary heart disease [3]. Persons with familial hypercholesterolemia commonly develop premature atherosclerosis and clinical atheroscle- rotic cardiovascular diseases (ASCVD) even in the absence of other risk factors [4]. Adverse risk factors induced by Abstract Hyperlipidemia is one of the main contribut- ing factors in the development of cardiovascular diseases. The hunt for effective antihyperlipidemic drugs is still on with an intention of finding potent agents with meager adverse effects. For the past several decades, medicinal plants have been evaluated for lipid-lowering effects apart from synthetic approaches to develop newer antihyperlipi- demic agents. This article highlights the work carried out on potential antihyperlipidemic agents from plant sources from 2006 till 2012 that were archived in Google Scholar and Science Direct database. Seventy-nine articles were included in the review after manual content curation. The review summarizes the investigations on medicinal plants, compounds and herbal formulations using various hyper- lipidemic animal models or in humans, the research find- ings and possibility of chemotaxonomic occurrence of sec- ondary metabolites responsible for the antihyperlipidemic activities within certain plant families. Keywords Antihyperlipidemic · Hypolipidemia · Medicinal plants · Natural products Abbreviations ACAT Acyl-coenzyme A: cholesterol acyltransferase AI Atherogenic index ASCVD Atherosclerotic cardiovascular diseases CRI Coronary risk index S. A. M. Saghir · V. Revadigar · V. Murugaiyah (*) Discipline of Pharmacology, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia e-mail: vicky@usm.my S. A. M. Saghir e-mail: sultan_a1976@yahoo.com