A form of fermented rice used as a herbal remedy and a colouring agent in food has shown remarkable results in patients who have suffered heart attacks.

Red yeast rice cut the risk of dying from a second heart attack by almost a third, and the risk of a non-fatal heart attack by almost two thirds, a trial in 5,000 people in China showed.

The results sound incredible but the trial was well-conducted and large, and the findings highly statistically significant.

They are less hard to believe when it is remembered that red yeast rice was the source of the first statin drug, lovastatin. So, in effect, the patients treated with red yeast rice were being given a statin in raw form.

Red yeast rice is made by fermenting rice with a yeast called Monascus purpureus. The result is a purple form of rice, known throughout the Far East under different names and sold in markets. It is also used to colour food.

In the trial, published online in the American Journal of Cardiology, 5,000 patients of both sexes who had already had a heart attack were divided into two groups and randomly allocated to be treated either with an extract of the red yeast rice, called XZK, or a placebo. They were then followed for an average of four and a half years.

The research team, led by Dr Daniel Capuzzi of Thomas Jefferson University in Philadelphia, counted how many patients in each group suffered a serious second heart attack (including those who died from one). They found that the risk was reduced by almost half in the group given XZK.

There was also a dramatic drop in the number of cancer deaths, but the numbers were too small to draw any real conclusions — 29 cancer deaths in those on placebo, 13 in those on XZK.

Dr Capuzzi said that the health benefits from red yeast rice even exceeded those of statins, the acclaimed cholesterol-lowering drugs.“I think it is surprising that a natural product like XZK would have this great an effect” he said.

“If further testing and study prove true, my hope is that XZK becomes an important therapeutic agent to treat cardiovascular disorders and in the prevention of disease whether someone has had a heart attack or not.

“But it is important to recognise that we do not know exactly how Chinese red yeast rice works. The exact ingredients from the XZK capsules have not been isolated and studied yet. Still, the results were so profound, even outperforming statins prescribed in numerous Western populations, that further study should certainly be investigated.”

Red yeast rice has been used in China for thousands of years as a food preservative, colorant and seasoning and herbal medicine. It is the ingredient that gives Peking duck its red colour.

Dr Capuzzi, who led the study together with Dr Zonliang Lu, from the Chinese Academy of Medical Science in Beijing, pointed out that the capsules used in the study were carefully prepared for the research and were not the same as red yeast rice supplements available in health food stores.

“Those over-the-counter supplements are not regulated, so exact amounts of active ingredient are unknown and their efficacy has not been studied yet,” he said.

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