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Endothelial dysfunction: clinical strategies for treating oxidant stress
Brett E Fenster1, Philip S Tsao, Stanley G Rockson
1Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, Calif 94305, USA.
American Heart Journal
|August 2, 2003
Summary
Oxidative stress contributes to endothelial dysfunction. While antioxidants show mixed results, conventional cardiovascular therapies effectively improve endothelial function by targeting vascular oxidative processes.
Area of Science:
- Cardiovascular Science
- Oxidative Stress Research
- Endothelial Function
Background:
- Oxidants are key in endothelial dysfunction pathogenesis.
- Oxidant stress modulates LDL oxidation, nitric oxide bioavailability, and vascular inflammation.
- Therapeutic strategies increasingly target oxidant stress to reverse endothelial dysfunction.
Purpose of the Study:
- To review preclinical and clinical studies on antioxidants and traditional therapies for oxidative stress and endothelial dysfunction.
- To evaluate the efficacy of various agents in ameliorating endothelial dysfunction.
Main Methods:
- MEDLINE search of English language articles (1992-2002).
- Review of preclinical and clinical studies.
- Evaluation of antioxidants and conventional cardiovascular therapies.
Main Results:
- Antioxidants (Vitamins C and E) show conflicting clinical results despite preclinical promise.
- Conventional therapies (ACE inhibitors, statins, insulin sensitizers, estrogens) alleviate endothelial dysfunction.
- Therapeutic benefits are often independent of systemic disease effects.
Conclusions:
- Conventional cardiovascular therapies restore endothelial function.
- These agents exert beneficial effects on pathological vascular oxidative processes.