The monomeric catechins and oligomeric procyanidins are thought to contribute to a hypocholesterolaemic effect. This may occur through a variety of mechanisms including an upregulation of hepatic LDL receptors, enhanced degradation of cholesterol to bile acids and suppression of cholesterol biosynthesis (Rajendran et al 1996), as well as inhibition of cholesterol absorption mediated by downregulation of intestinal acyl CoA:cholesterol acyltransferase activity (Zhang et al 2002).

A traditional multi-herbal Chinese formula containing hawthorn has been found to prevent experimental hypercholesterolemia in rats, probably due to its choleretic function (Cheng et al 2004). A different multi-herbal Chinese formula was also found to protect vascular endothelial cells from excess cholesterol in vivo (Tu et al 2003).

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