Antioxidant vitamins and heart disease prevention

Coronary heart disease (CHD) is a major cause of mortality and morbidity worldwide. About 13 million Americans have CHD, 1.5 million have a myocardial infarction (MI) each year, and about 450,000 die of CHD each year (1). It is of great public health benefit to find simple, feasible, and cost-effective preventive therapies that decrease the incidence of CHD. Research on the cause of CHD has been ongoing for approximately a century (2). It is known that CHD is caused by atherosclerosis, a process characterized by endothelial dysfunction in association with hypertension, diabetes, smoking, and elevated homocysteine concentrations and cholesterol deposition in macrophages and smooth muscle cells in the arterial wall as the result of elevated low-density lipoproteins (LDLs) and remnant lipoproteins as well as decreased high-density lipoproteins (HDLs). In addition, smooth muscle proliferation, inflammation, thrombosis, and calcification occur in this process. The basis of therapy for CHD is its prevention through the modification of risk factors (3).