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Alarming increase in incidence of cardiovascular disease is result of a nutrition pattern characterized by an increase in consumption of fats, cholesterol, sugar and other refined carbohydrates, concomitant with low consumption of polyunsaturated fatty acids and fibers. The purpose of this study was to evaluate the efficacy of the monacolin K of red rice and glucomannan, associated with low-calorie diet, on improvement of lipid profile and hypertension, symptoms of metabolic syndrome. In 180 Neapolitan patients with metabolic syndrome, we evaluated effects of monacolin K of red rice and glucomannan, associated with a low-calorie diet, on total cholesterol (CT), LDL cholesterol (LDL), HDL cholesterol (HDL), triglycerides (TG) and blood pressure (BP). The results showed a significant decrease in average value of CT (-20%), LDL (-25%), TG (-20%), with an increase in HDL (+15%) and a decrease in BP (-20%). These findings corroborate evidences showing a therapeutic effects of these nutraceuticals in the treatment of dyslipidemia and hypertension, when a low-calorie diet alone is ineffective.