Antioxidant status, fatty acids, and cardiovascular disease.

Oxidative modification of low-density lipoprotein (LDL) cholesterol may contribute to atherosclerosis by several mechanisms demonstrated in vitro. Antioxidants have been shown to inhibit this process in vitro, and there is evidence from animal studies that they protect against atherosclerosis in vivo. The results of human studies examining the association between antioxidants and cardiovascular disease (coronary heart disease, hypertensive heart disease, and stroke) have been equivocal, although evidence is accumulating that suggests a beneficial effect. Recently, monounsaturated fatty acids incorporated into LDL have been shown to be resistant to oxidation in vitro, compared to polyunsaturated fatty acids. Results from short-term clinical studies are consistent with this finding, as are some epidemiologic data, which suggest that diets containing monounsaturated fatty acids are associated with decreased mortality from cardiovascular disease. The overall roles of antioxidants and particular fatty acids in preventing atherosclerosis require further elucidation.