Primary and secondary prevention of atherosclerosis: Is there a role for antioxidants?

Elevated plasma free radical concentration (expression of enhanced oxidativ e stress) is related to different pathophysiological conditions such as age ing, cancer and diabetes. Nevertheless, even in healthy subjects a rise in plasma free radicals is due to hyperglycaemia, elevated free fatty acids an d hyperinsulinaemia. Once elevated oxidative stress occurs, accelerated ath erosclerosis may be present Thus, antioxidants might potentially be useful in preventing or delaying the development of atherosclerosis. Several epide miological studies have provided conflicting results, whereas interventiona l studies have demonstrated that antioxidant administration at pharmacologi cal doses is useful for secondary prevention of atherosclerosis. The role o f antioxidants in diabetic patients is still debatable, and it is tao early to suggest this means far the prevention of atherosclerosis. Concerning tr ace elements, several studies have indicated that iron, copper, zinc and se lenium may play a role in the pathogenesis of atherosclerosis. Nevertheless , only future longitudinal studies can provide a final response. In conclus ion, the whole body of studies to date clearly demonstrates that antioxidan ts may be useful far secondary prevention of coronary heart disease.