Objective: To assess the evidence supporting the role of oxidative stress in the pathogenesis of atherosclerosis, endothelial dysfunction, platelet aggregation and heart failure, and to evaluate the status of antioxidant therapy in the clinical management of cardiovascular disease.
Data sources: No attempt was made to provide insight into mechanisms of oxidative stress and the response to antioxidant intervention. Human studies were scrutinized for evidence that oxidative stress was present and whether antioxidant therapy provides clinical benefit.
Conclusions: There is ample evidence that oxidative stress is involved in the pathogenesis of atherosclerosis, endothelial dysfunction, platelet aggregation and heart failure. However, the extrapolation of this evidence to the use of antioxidant therapy in primary or secondary prevention of cardiovascular disease cannot be justified at this time.