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Antioxidant vitamins and cardiovascular disease.

The hypothesis that antioxidant vitamins may reduce risks of cardiovascular disease has been the subject of considerable research attention in recent years. Basic research studies have provided evidence of possible mechanisms for an effect of antioxidants on atherosclerosis, and several observational epidemiologic studies have suggested that risk of coronary heart disease (CHD) may be 20–40% lower among those with high dietary intake or serum levels of antioxidant vitamins. CHD remains the leading cause of death in the United States, as well as most developed countries, accounting for approximately one of every four deaths. For this reason, even the modest reductions in CHD risk suggested by studies to date, if real, could yield substantial public health benefits. At present, however, available data remain inadequate to draw firm conclusions regarding the possible role of antioxidant vitamins in the prevention of cardiovascular disease. This chapter reviews the evidence on antioxidants and cardiovascular disease, discusses its strengths and limitations, and summarizes the trials now ongoing.