The role of oxidative stress, antioxidants and vascular inflammation in cardiovascular disease (a review)

Vascul Pharmacol. 2015 Aug;71:40-56. doi: 10.1016/j.vph.2015.03.005. Epub 2015 Apr 11.

Abstract

The concept of mild chronic vascular inflammation as part of the pathophysiology of cardiovascular disease, most importantly hypertension and atherosclerosis, has been well accepted. Indeed there are links between vascular inflammation, endothelial dysfunction and oxidative stress. However, there are still gaps in our understanding regarding this matter that might be the cause behind disappointing results of antioxidant therapy for cardiovascular risk factors in large-scale long-term randomised controlled trials. Apart from the limitations of our knowledge, limitations in methodology and assessment of the body's endogenous and exogenous oxidant-antioxidant status are a serious handicap. The pleiotropic effects of antioxidant and anti-inflammation that are shown by some well-established antihypertensive agents and statins partly support the idea of using antioxidants in vascular diseases as still relevant. This review aims to provide an overview of the links between oxidative stress, vascular inflammation, endothelial dysfunction and cardiovascular risk factors, importantly focusing on blood pressure regulation and atherosclerosis. In view of the potential benefits of antioxidants, this review will also examine the proposed role of vitamin C, vitamin E and polyphenols in cardiovascular diseases as well as the success or failure of antioxidant therapy for cardiovascular diseases in clinical trials.

Keywords: Antioxidant; Atherosclerosis; Hypertension; Inflammation; Oxidative stress.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use
  • Antioxidants / pharmacology
  • Antioxidants / physiology*
  • Antioxidants / therapeutic use*
  • Ascorbic Acid / metabolism
  • Ascorbic Acid / pharmacology
  • Ascorbic Acid / therapeutic use
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / metabolism*
  • Endothelium, Vascular / drug effects
  • Endothelium, Vascular / metabolism*
  • Humans
  • Hypertension / drug therapy
  • Hypertension / metabolism
  • Inflammation / drug therapy
  • Inflammation / metabolism
  • Oxidative Stress / drug effects
  • Oxidative Stress / physiology*
  • Reactive Oxygen Species / metabolism
  • Risk Factors
  • Vitamin E / metabolism
  • Vitamin E / pharmacology
  • Vitamin E / therapeutic use

Substances

  • Antihypertensive Agents
  • Antioxidants
  • Reactive Oxygen Species
  • Vitamin E
  • Ascorbic Acid