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Antioxidants in cardiovascular pathology Volume 18, issue 4, Avril 2006

Author
Laboratoire des Lipides, hôpital de la Pitié, 83, boulevard de l’Hôpital, 75651 Paris Cedex 13, Laboratoire de Biochimie métabolique et clinique (EA 3617), faculté de Pharmacie, 4, avenue de l’Observatoire, 75270 Paris Cedex 06

The results of large-scale trials with antioxidant vitamin supplementation in cardiovascular disease (CVD) have generally been disappointing and failed to prove any protective effect of these vitamins, especially vitamin E. However, the oxidative theory of atherosclerosis that confers proatherogenic properties to oxidized lipoproteins has raised hopes for more than fifteen years with these antioxidant treatments. In contrast with supplementation studies, many observational studies have found an association between antioxidant consumption (especially vitamin E) and a reduced risk of coronary heart disease ; moreover, people who consume a diet rich in fruits and vegetables have lower risks of CVD. This addresses the question of the opportunity of antioxidant supplements to reduce cardiovascular risk. The factors that could explain the relative inefficiency of the antioxidant vitamin supplementation will be discussed in this review. At present, there is not enough data from randomized trials to justify establishment of recommendations regarding the use of vitamin E for CVD prevention. The best approach is to recommend a balanced diet with antioxidant-rich fruits and vegetables. Even if future clinical trials demonstrate a clear beneficial role of antioxidant supplementation, this should always be adjuvantt therapy, with a strict respect of the cardioprotective measures (physical activity, control of blood pressure and dyslipidemia, limitation of risk factors such as obesity and smoking).