Antioxidant Vitamin Supplements and Cardiovascular Disease

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Abstract
The American Heart Association (AHA) has had a long-standing commitment to provide information about the role of nutrition in cardiovascular disease (CVD) risk reduction. Many activities have been and are currently directed toward this objective, including issuing AHA Dietary Guidelines periodically (most recently in 20001) and Science Advisories and Statements on an ongoing basis to review emerging nutrition-related issues. The objective of the AHA Dietary Guidelines is to promote healthful dietary patterns. A consistent focus since the inception of the AHA Dietary Guidelines has been to reduce saturated fat (and trans fat) and cholesterol intake, as well as to increase dietary fiber consumption. Collectively, all the AHA Dietary Guidelines have supported a dietary pattern that promotes the consumption of diets rich in fruits, vegetables, whole grains, low-fat or nonfat dairy products, fish, legumes, poultry, and lean meats. This dietary pattern has a low energy density to promote weight control and a high nutrient density to meet all nutrient needs. As reviewed in the first AHA Science Advisory2 on antioxidant vitamins, epidemiological and population studies reported that some micronutrients may beneficially affect CVD risk (ie, antioxidant vitamins such as vitamin E, vitamin C, and β-carotene). Recent epidemiological evidence3 is consistent with the earlier epidemiological and population studies (reviewed in the first Science Advisory).2 These findings have been supported by in vitro studies that have established a role of oxidative processes in the development of the atherosclerotic plaque. Underlying the atherosclerotic process are proatherogenic and prothrombotic oxidative events in the artery wall that may be inhibited by antioxidants. The 1999 AHA Science Advisory2 recommended that the general population consume a balanced diet with emphasis on antioxidant-rich fruits, vegetables, and whole grains, advice that was consistent with the AHA Dietary Guidelines at the time. In the absence of …