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Review Article
Mechanisms of Disease
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Volume 337:408-416 August 7, 1997 Number 6
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Antioxidants and Atherosclerotic Heart Disease
Marco N. Diaz, M.D., Balz Frei, Ph.D., Joseph A. Vita, M.D., and John F. Keaney, M.D.

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Epidemiologic studies have demonstrated an association between increased intake of antioxidant vitamins such as vitamin E and vitamin C and reduced morbidity and mortality from coronary artery disease. This association has been explained on the basis of the "oxidative-modification hypothesis" of atherosclerosis, which proposes that atherogenesis is initiated by oxidation of the lipids in low-density lipoprotein (LDL), also termed lipid peroxidation. As a corollary to this hypothesis, antioxidants that inhibit lipid peroxidation in LDL should limit atherosclerosis and its clinical manifestations, such as myocardial infarction and stroke. In this review, we will evaluate the current literature involving antioxidants and vascular . . . [Full Text of this Article]

Human Studies Linking Antioxidants with a Reduction in Cardiovascular Events

The Oxidative-Modification Hypothesis of Atherosclerosis

Relation between Resistance of LDL Particles to Oxidation and Atherosclerosis in Animals

Resistance of LDL to Oxidation in Humans

Inhibition of LDL Oxidation and Reduction in Coronary Events

Problems in Linking Increased Resistance of LDL to Oxidation with Inhibition of Atherosclerosis

Vascular Effects of Antioxidants Related to the Resistance of LDL to Oxidation

Reduced Cytotoxicity

Endothelium-Derived Nitric Oxide

Vascular Effects of Antioxidants Not Strictly Related to the Protection of LDL from Oxidation

Preservation of Endothelium-Derived Nitric Oxide Action

Inhibition of Leukocyte Adhesion

Reduction of Cellular Oxidative Injury

Inhibition of Platelet Activation and Smooth-Muscle Proliferation

Summary


Source Information

From the Evans Memorial Department of Medicine (M.N.D., B.F., J.A.V., J.F.K.) and the Whitaker Cardiovascular Institute (B.F., J.A.V., J.F.K.), Boston University School of Medicine, Boston.

Address reprint requests to Dr. Keaney at the Whitaker Cardiovascular Institute, Boston University School of Medicine, 80 E. Concord St., Rm. W507, Boston, MA 02118.

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