Antioxidants and heart disease: Epidemiology and clinical evidence

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Abstract
One in three Americans will eventually die of cardiovascular disease. Antioxidant vitamins, which are postulated to reduce risk by about 20–30%, could have substantial clinical and public health impact. Basic research, clinical observation, and epidemiology have contributed to an emerging body of evidence on the atherogenicity of oxidized low‐density lipoprotein, which could be an important mechanism to explain why antioxidant vitamins may decrease risk of coronary disease. The antioxidant‐vitamin/cardiovascular‐disease hypothesis has recently been explored in several large prospective cohort studies, but the findings were not all consistent. In several randomized, small‐scale trials using subjects with existing vascular disease, data indicate benefits associated with vitamin E and β carotene. Over the next several years, data from a number of ongoing primary prevention trials and proposed secondary prevention trials should determine whether antioxidant vitamins decrease risk of vascular disease.