Neutrophil free oxygen radical production and blood total antioxidant capacity in patients with coronary heart disease using various medications

Despite convincing results of studies in vitro, less is known about the eff ects of antioxidants on in vivo redox balance in humans. We developed a nov el parameter of in vivo redox balance, and studied it and its relation to d ental infections in 51 patients on medication for coronary heart disease (C HD) and 39 random controls matched for age group, sex, social class and loc ality. In vivo redox balance was the ratio of plasma antioxidant capacity, as measured with radical-trapping assay, to neutrophil respiratory burst ca pacity, as measured with whole blood chemiluminescence assay. Dental infect ions were quantitated with four rating scales. CHD patients had higher valu es than controls. Patients on acetosalicylic acid (ASA), diuretics or beta blockers, but not the ones on calcium channel blocker, had significantly hi gher redox balance than non-users. Combination of calcium channel blockers and ASA was associated with redox balance similar to taking beta blockers o r diuretics. Diuretics and ASA were independent determinants of redox balan ce in multivariate analyses. Redox balance did not correlate with severity of dental infections (Spearman's r 0.06 to 0.11). The results contrast expe rimental data indicating that calcium channel blockers are as antioxidants superior to other cardiovascular drugs. Total antioxidant capacity in paral lel with oxygen species production capacity should be considered in attempt s to solve the antioxidant paradox.