Antioxidants in cardiovascular health and disease: Key lessons from epidemiologic studies
Antioxidants in cardiovascular health and disease: Key lessons from epidemiologic studies
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DOI：
10.1016/j.amjcard.2008.02.012
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发表时间：
2008-05-22
影响因子：
2.8
通讯作者：
Rodriguez, Beatriz L.
中科院分区：
文献类型：
--
作者：
Willcox, Bradley J.;Curb, J. David;Rodriguez, Beatriz L.
衰老的自由基理论认为，氧化应激是衰老和年龄相关疾病（包括心血管疾病）的主要机制之一。许多体外和动物研究支持低密度脂蛋白（LDL）氧化在动脉粥样硬化中的作用。这导致了一种假设，即抗氧化剂可以用作预防和可能治疗冠状动脉疾病、中风、外周血管疾病和其他CVD相关疾病的廉价手段。大量男性、女性和不同人群的流行病学队列研究在很大程度上支持这一假设。然而，干预性试验一直存在争议，有一些积极的发现，许多无效的发现，并在某些高危人群中的伤害的一些建议。由于流行病学研究和干预性试验之间的不匹配，一些研究人员主张终止抗氧化剂的工作。其他人质疑LDL氧化假说本身的有效性。显然，需要进一步的研究来了解流行病学和干预工作之间不匹配的原因。最近对精心挑选的人群（如处于高水平氧化应激下的人群）进行的较小规模的干预性研究取得了很大的积极成果。这表明我们需要更多的假设驱动和严格的临床试验设计。这将有助于澄清抗氧化剂在CVD中的真正潜在效用，并可能导致更好地理解氧化应激在动脉粥样硬化中的作用。(C)2008年爱思唯尔公司All rights reserved.
The free radical theory of aging posits that oxidative stress is among the major mechanisms in aging and age-related disease, including cardiovascular disease (CVD). Numerous in vitro and animal studies have supported the role of low-density lipoprotein (LDL) oxidation in atherosclerosis. This has led to the hypothesis that antioxidants could be used as an inexpensive means of prevention and possibly, treatment of coronary artery disease, stroke, peripheral vascular disease, and other CVD-related diseases. Epidemiologic cohort studies with large numbers of men, women, and diverse populations have been largely supportive of this hypothesis. However, interventional trials have been controversial, with some positive findings, many null findings, and some suggestion of harm in certain high-risk populations. Because of the mismatch between the epidemiologic studies and the interventional trials, some researchers have advocated ending antioxidant work. Others have questioned the validity of the LDL oxidative hypothesis itself. Clearly, further research is needed to understand the reasons for the mismatch between the epidemiologic and interventional work. Recent smaller interventional studies with carefully chosen populations, such as those under high levels of oxidative stress, have yielded largely positive results. This suggests that we need more hypothesis-driven and rigorous clinical trial designs. This should help clarify the true potential utility of antioxidants in CVD and may lead to a better understanding of the role of oxidative stress in atherosclerosis. (C) 2008 Elsevier Inc. All rights reserved.