Antioxidants in hypertension and cardiovascular disease.

Cardiovascular disease is characterized by enhanced oxidative stress in the vascular wall, heart, kidney, and brain. Epidemiological evidence suggests that antioxidants, including vitamins C and E, α-carotene, and β-carotene, may be therapeutic; however, interventional trials of antioxidants have provided mixed results, with some showing deleterious consequences. It is thus crucial that we consider the implications of trial design and execution, and further investigation of cellular pro-and antioxidant mechanisms is critical. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and mineralocorticoid receptor blockers reduce the generation of reactive oxygen species, in experimental models as well as in humans, and have demonstrated beneficial cardiovascular effects. Polyphenols and antioxidants contained in foods and beverages may also be cardioprotective. Recent studies suggest that the judicious development of antioxidant agents may provide an effective approach to quench oxidative stress in tissues and improve cardiovascular health.