Reactive Oxygen Species and the Cardiovascular System

Table 1

Major studies with possible beneficial effects of AOs on cardiovascular outcomes in humans.

Author/study	Journal	Design/FU	Population*	Agents (dosage/day)	Results
Stephens et al./CHAOS [52]	The Lancet	DB, PC; 1.4 y (3 d–3 y)	𝑁 = 2002; M and F; mean 61.8 y; ischemic heart disease patients; secondary prevention	E (800 mg or 400 IU)	↓ ↓ I nonfatal MI, trend ↑ CV death
Duffy et al. [53]	The Lancet	DB, PC; 30 d	𝑁 = 45; M and F; mean 48.5 y; HT patients	C (500 mg)	↓ BP in otherwise healthy HT
Boaz et al./SPACE [54]	The Lancet	DB, PC; 2 y	𝑁 = 196; M and F; 40–75 y; haemodialysis patients	E (800 IU)	↓ ↓ combined endpoint of AMI = CV death + stroke
Neri et al. [55]	Clinical Therapeutics	DB, PC; 15 d	𝑁 = 46; M and F; mean 40 y; DM/glucose intolerance patients	NAC (600 g) + C (250 mg) + E (300 mg)	↓ OS and inflammation
Accini et al. [56]	Nutrition, Metabolism and Cardiovascular Diseases	DB, PC; 4 m	𝑁 = 57; M and F; 23–65 y; dyslipidemic patients	E (4 mg); PUFAn-3 (6602 mg EPA + 440 DHA); niacin (18 mg); γOZ (40.2 mg)	↓ OS and inflammation markers

The CHAOS study is the largest study to report a strong decrease in nonfatal MI but, conversely, a slight increase in cardiovascular death. Other studies were performed in smaller groups. Overall, no overwhelming positive effects could be found in the studies. Population*: 𝑁: number of patients; M: male; F: female; y: age in years. DB: double blind; PC: placebo controlled; d: days; m: months; E: vitamin E; C: vitamin C; NAC: N-acetylcysteine; PUFAn-3: polyunsaturated fatty acids n-3; EPA: eicosapentaenoic; DHA: docosahexaenoic; γOZ: γ-oryzanol; I: incidence; BP: blood pressure; CV: cardiovascular; MI: myocardial infarction; HT: hypertension; AMI: acute myocardial infarction; OS: oxidative stress.