Olguín CG, Meléndez MG, Zúñiga RA, Pasquetti CA

Idioma: Español
Referencias bibliográficas: 38
Paginas: 199-206
Archivo PDF: 119.19 Kb.

RESUMEN

Los datos que implican a los radicales libres en la oxidación de las lipoproteínas de baja densidad (LDL), promoviendo su captura por parte de los macrófagos en la pared arterial, son contundentes: la peroxidación lipídica es factor iniciador en la formación de la placa de ateroma. Los antioxidantes pueden prevenir la peroxidación y en forma subsecuente disminuir el riesgo cardiovascular. A pesar de que en los estudios observacionales la población que consume un alto contenido de vitaminas antioxidantes en su dieta (frutas y verduras) tiene una menor incidencia de infartos cardíacos y eventos vasculares cerebrales, los estudios clínicos controlados, en donde los antioxidantes se administran en dosis fijas como suplementos vitamínicos, no han podido mostrar efectos benéficos en cuanto a prevención primaria o secundaria de enfermedad cardiovascular e incluso en algunas poblaciones se han presentado eventos adversos. Con la evidencia que se cuenta hasta el momento, las recomendaciones para el consumo de antioxidantes es que ésta debe hacerse a través de la dieta y no mediante la suplementación con vitamínicos.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Prior RL. Fruits and vegetables in the prevention of cellular oxidative damage. Am J Clin Nutr 2003; 78(Suppl): 570S-578S.

2. Steinberg D, Parthasarathy S, Carew TE et al. Modifications of Low-Density Lipoprotein that increase its atherogenicity. N Engl J Med 1989; 320(14): 915-924.

3. Esterbauer H et al. Role of vitamin E in preventing the oxidation of low-density lipoprotein. Am J Clin Nutr 1991; 53(Suppl): 314S-321S.

4. Díaz MN, Frei B, Vita JA et al. Antioxidants and atherosclerotic Heart disease. N Engl J M 1997; 337(6): 408-414.

5. Halliwell B. Free radicals, antioxidants, and human disease: curiosity, cause, or consequence? Lancet 1994; 344: 721-724.

6. Biesalski HK. Free radical theory of aging. Curr Opin Clin Nutr Metab Care 2002; 5: 5-10.

7. Fürst P. The role of antioxidants in nutritional support. Proc Nutr Soc 1996; 55: 945-961.

8. Harrison D, Griendling K, Landmesser U et al. Role of oxidative stress in atherosclerosis. Am J Cardiol 2003: 91(3A): 7A-11A.

9. Duthie GG, Bellizzi MC. Effects of antioxidants on vascular health. Br Med Bull 1999; 55(3): 568-577.

10. Clark SF. The biochemistry of antioxidants revisited. Nutr Clin Prac 2002; 17: 5-17.

11. Frei B. Ascorbic acid protects lipids in human plasma and low-density lipoprotein against oxidative damage. Am J Clin Nutr 1991; 154: 1113S-1118S.

12. Ross R. Atherosclerosis- An inflammatory disease. N Engl J Med 1999; 340(2): 115-126.

13. Huang HY. Effects of vitamin C and vitamin E on in vivo lipid peroxidation: results of a randomized controlled trial. Am J Clin Nutr 2002; 76: 549-555.

14. De Gaetano G. Low dose aspirin and vitamin E in people at cardiovascular risk a randomized trial in general practice. Collaborative Group of the Primary Preventive Project. Lancet 2001: 357-389.

15. Asplund K. Antioxidant vitamins in the prevention of cardiovascular disease: a systematic review. J Intern Med 2002; 251: 372-392.

16. US Preventive Services Task Force. Routine vitamin supplementation to prevent cancer and cardiovascular disease: Recommendations and rationale. Ann Intern Med 2003; 139(1): 51-55.

17. Vivekananthan DP et al. Use of antioxidant vitamins for the prevention of cardiovascular disease: meta-analysis of randomized trials. Lancet 2003: 361: 2017-2023.

18. Hu FB. Plant-based foods and prevention of cardiovascular disease: an overview. Am J Clin Nutr 2003; 78(Suppl): 544S-551S.

19. Morris CD, Carson S et al. Routine vitamin supplementation to prevent cardiovascular disease: A summary of the evidence for the US preventive services task force. Ann Intern Med 2003; 139: 56-70.

20. Rimm EB et al. Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med 1993; 328: 1450-1456.

21. Losonczy KG, Harris TB, Havlik RJ. Vitamin E and vitamin C supplement use and risk of all-cause and coronary heart disease mortality in older persons: the Established Population for Epidemiologic Studies of the Elderly. Am J Clin Nutr 1996; 64: 190-196.

22. Kushi LH et al. Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. N Engl J Med 1996; 334: 1156-1162.

23. Muntwyler J et al. Vitamin supplement use in a low-risk population of US male physicians and subsequent cardiovascular mortality. Arch Intern Med 2002; 162: 1472-1476.

24. Knekt P, Reunanen A, Jarvinen R et al. Antioxidant vitamin intake and coronary mortality in a longitudinal population study. Am J Epidemiol 1994; 139: 1180-1189.

25. Stephens NG, Parsons S, Schofield PM et al. Randomized controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet 1996; 347: 781 -786.

26. The Heart Outcome Prevention Evaluation Study Investigators. Vitamin E supplementation and cardiovascular events in high-risk patients. N Engl J Med 2000; 342: 154-160.

27. The Alpha-Tocopherol Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994; 330: 1029-1035.

28. Omenn GS, Goodman GE, Thornquist MD et al. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. (CARET) N Engl J Med 1996; 334: 1150-1155.

29. Stampfer MJ, Hennekens CH, Manson JE et al. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 1993; 328: 1444-1449.

30. Hennekens CH, Buring JE, Manson JE et al. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 1996; 334: 1145-1149.

31. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20,536 high-risk individuals: a randomized placebo-controlled trial. Lancet 2002; 360: 23-33.

32. Willet WC, Stampfer MJ. What vitamins should I be taking, doctor? N Engl J M 2001; 345(25): 1819-1824.

33. Steinberg D. Clinical trials of antioxidants in atherosclerosis: are we doing the right thing? Lancet 1995; 346: 36-39.

34. Brown BG, Cheung MC, Lee AC et al. Antioxidant vitamins and lipid therapy. End of a long romance? Arterioescler Thromb Vasc Biol 2002; 22: 1535-1546.

35. Hathcock JN. Vitamins and minerals: efficacy and safety. Am J Clin Nutr 1997; 66: 427-437.

36. Morrow JD, Frei B, Lomgmire AW et al. Increase in circulating products of lipid peroxidation (F2-isoprostanes) in smokers. N Engl J M 1995; 332(18): 1198-1203.

37. Meaghear EA, Barry OP, Lawson JA et al. Effects of vitamin E on lipid peroxidation in healthy persons. JAMA 2001; 285(9): 1178-1182.

38. Heinecke JW. Is the Emperor Wearing Clothes? Clinical Trials of vitamin E and LDL oxidation hypothesis. Arterioscler Thromb Vasc Biol 2001; 21: 1261-1264.