title: Why do antioxidants fail to provide clinical benefit?
abstract: The results of recent randomized trials to test the influence of antioxidants on coronary-event rates and prognosis in patients with coronary-artery disease were disappointing. In none of these studies did the use of vitamin E improve prognosis. In contrast, treatment of coronary-artery disease with angiotensin-converting-enzyme (ACE) inhibitors reduced coronary-event rates and improved prognosis. ACE inhibition prevents the formation of angiotensin II, which has been shown to be a potent stimulus of superoxide-producing enzymes in atherosclerosis. The findings suggest that inhibition of superoxide production at enzymatic levels, rather than symptomatic superoxide scavenging, may be the better choice of treatment.
authors.affiliation: University Hospital Eppendorf, Division of Cardiology, Hamburg, Germany. muenzel@uke.uni-hamburg.de
authors.forename: Ascan
authors.initials: A
authors.lastname: Warnholtz
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel