Encyclopedia of Heart Diseases

2011 Edition
| Editors: M. Gabriel Khan


Reference work entry
DOI: https://doi.org/10.1007/978-1-60761-219-3_14


Steinberg et al. ( 1989) were among the first to indicate that modified low-density lipoprotein cholesterol (LDL-C) could be responsible for the accumulation of lipid within macrophages, a crucial step in the early formation of atheromatous plaques (  Cholesterol).
  • Basic research suggested that vitamin E, vitamin C, and other antioxidants reduce cardiovascular disease by trapping organic free radicals or deactivating excited oxygen molecules, or both, to prevent tissue damage (Packer 1991).

  • Antioxidants may slow atherosclerotic plaque formation by inhibiting LDL-C oxidation (Steinberg and Lewis 1997) modifying platelet activity (Steiner 1999; Mabile et al. 1999) and ameliorating endothelial dysfunction.

Only some antioxidants prevent the oxidation of LDL cholesterol, which plays an important role in the pathogenesis of the atherosclerotic process and its progression to blockage of arteries (  Atherosclerosis/Atherothrombosis and  Angina). The harmful effect of LDL cholesterol is...
This is a preview of subscription content, log in to check access.



  1. Bjelakovic G, Nikolova D, Gluud LL et al (2008) Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev 2:CD007176PubMedGoogle Scholar
  2. Cuveas AM, Guasch V, Castillo O et al (2000) A high-fat diet induces and red wine counteracts endothelial dysfunction in human volunteers. Lipids 35:143–148Google Scholar
  3. de Lorgeril M, Renaud S, Mamelle N et al (1994) Mediterranean alpha-linolenic acid rich diet in secondary prevention of coronary heart disease. Lancet 343:1454PubMedGoogle Scholar
  4. Fisher ND, Hollenberg NK (2005) Flavanols for cardiovascular health: the science behind the sweetness. J Hypertens 23:1453–1459PubMedGoogle Scholar
  5. Flammer AJ, Hermann F, Sudano I et al (2007) Dark chocolate improves coronary vasomotion and reduces platelet reactivity. Circulation 116:2376–2382PubMedGoogle Scholar
  6. Freedman JE, Parker C, Li L (2001) Select flavonoids and whole juice from purple grapes inhibit platelet function and enhance nitric oxide release. Circulation 103:2792–2798PubMedGoogle Scholar
  7. Hlatky MA (2008) Expanding the orbit of primary prevention – moving beyond JUPITER. N Engl J Med 359; Published at www.nejm.org, November 9, 2008
  8. Hollenberg NK, Fisher NDL (2007) Is it the dark in dark chocolate? Circulation 116(21):2360–2362PubMedGoogle Scholar
  9. Lee IM, Cook NR, Gaziano JM et al (2005) Vitamin E in the primary prevention of cardiovascular disease and cancer: the Women’s Health Study: a randomized controlled trial. JAMA 294(1):56–65PubMedGoogle Scholar
  10. Mabile L, Bruckdorfer KR, Rice-Evans C (1999) Moderate supplementation with natural alpha-tocopherol decreases platelet aggregation and low-density lipoprotein oxidation. Atherosclerosis 147(1):177–185PubMedGoogle Scholar
  11. Milman U, Blum S, Shapira C et al (2008) Vitamin E supplementation reduces cardiovascular events in a subgroup of middle-aged individuals with both Type 2 diabetes mellitus and the haptoglobin 2–2 genotype: a prospective double-blinded clinical trial. Arterioscler Thromb Vasc Bio 28:341–347Google Scholar
  12. Packer L (1991) Protective role of vitamin E in biological systems. Am J Clin Nutr 53(4 suppl):1050S–1055SPubMedGoogle Scholar
  13. Ridker PM, Danielson E, Fonseca F for the JUPITER Study Group (2008) Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 359:2195–2207Google Scholar
  14. Sesso HD, Buring JE, Christen WG et al (2008) Vitamins E and C in the prevention of cardiovascular disease in men. The Physicians’ Health Study II Randomized Controlled Trial. JAMA 300(18):2123–2133PubMedGoogle Scholar
  15. Steinberg D, Lewis A (1997) Conner memorial lecture: oxidative modification of LDL and atherogenesis. Circulation 95(4):1062–1071PubMedGoogle Scholar
  16. Steinberg D, Parthesarathy S, Carew TE et al (1989) Beyond cholesterol: modifications of low-density lipoprotein that increase its atherogenicity. N Engl J Med 320:915–924PubMedGoogle Scholar
  17. Steiner M (1999) Vitamin E, a modifier of platelet function: rationale and use in cardiovascular and cerebrovascular disease. Nutr Rev 57(10):306–309PubMedGoogle Scholar
  18. Stephens NG, Parsons A, Schofield PM et al (1996) Randomized controlled trial of vitamin E in patients with coronary disease: Cambridge Heart antioxidant study (CHAOS). Lancet 347:781–786PubMedGoogle Scholar
  19. Violi F, Cangemi R (2008) Statin treatment as a confounding factor in human trials with vitamin E. J Nutr 138:1179–1181PubMedGoogle Scholar
  20. Wallerath T, Poleo D, Li H et al (2003) Red wine increases the expression of human endothelial nitric oxide synthase. J Am Coll Cardiol 41:471–478PubMedGoogle Scholar
  21. Zitron E, Scholz E, Owen RW et al (2005) QTc prolongation by grapefruit juice and its potential pharmacological basis: HERG channel blockade by flavonoids. Circulation 111:835–838PubMedGoogle Scholar

Suggested Reading

  1. Corti R, Flammer AJ, Hollenberg NK et al (2009) Cocoa and cardiovascular health. Circulation 119(10):1433–1441PubMedGoogle Scholar
  2. Dohadwala MM, Vita JA (2009) Grapes and cardiovascular disease. J Nutr 139(9):1788S–1793SPubMedGoogle Scholar
  3. Opie LH, Lecour S (2007) The red wine hypothesis: from concepts to protective signalling molecules. Eur Heart J 28(14):1683–1693PubMedGoogle Scholar
  4. Soukoulis V, Dihu JB, Sole M et al (2009) Micronutrient deficiencies an unmet need in heart failure. J Am Coll Cardiol 54(18):1660–1673PubMedGoogle Scholar
  5. Streppel MT, Ocke MC, Boshuizen HC et al (2009) Long-term wine consumption is related to cardiovascular mortality and life expectancy independently of moderate alcohol intake: the Zutphen Study. J Epidemiol Community Health 63(7):534–540PubMedGoogle Scholar
  6. Violi F, Pignatelli P, Basili S (2010) Nutrition, supplements, and vitamins in platelet function and bleeding. Circulation 121(8):1033–1044PubMedGoogle Scholar

Case Studies

  1. Balzer J, Rassaf T, Heiss C et al (2008) Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trial. J Am Coll Cardiol 51:2141–2149PubMedGoogle Scholar
  2. Buijsse B, Feskens EJ, Kok FJ et al (2006) Cocoa intake, blood pressure, and cardiovascular mortality: the zutphen elderly study. Arch Intern Med 166:411–417PubMedGoogle Scholar
  3. Lonn E, Bosch J, Yusuf S et al for the The HOPE and HOPE-TOO Trial Investigators (2005) Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA 293(11):1338–1347. HOPE-TOOGoogle Scholar
  4. Monroe KR, Murphy SP, Kolonel LN et al (2007) Prospective study of grapefruit intake and risk of breast cancer in postmenopausal women: the multiethnic cohort study. Br J Cancer 97:440–445PubMedGoogle Scholar
  5. Sorond FA, Lipsitz LA, Hollenberg NK et al (2008) Cerebral blood flow response to flavanol-rich cocoa in healthy elderly humans. Neuropsychiatr Dis Treat 4:433–440PubMedGoogle Scholar
  6. The Alpha Tocopherol Beta-carotene Prevention Study Group (1994) The effect of vitamin E and beta-carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 330:1029–1035. ATBCGoogle Scholar

Copyright information

© Springer Science+Business Media LLC 2011