Oxidative Stress in Cardiovascular Disease: A New Avenue Toward Future Therapeutic Approaches

Oxidative stress is a common denominator in many aspects of the pathogenesis of atherosclerosis and cardiovascular diseases. Some drugs, such as vitamin C, vitamin E, and a free radical scavenger, edaravone, are prescribed with oxidative stress as their main target. Furthermore, the drugs in current clinical use, such as anti-hypertension reagents including angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB), and antihyperlipidemic reagents like statins, protect various organs, e.g., vessel, brain, heart, and kidney, via anti-oxidative stress effects in addition to their original pharmacological properties. While results of clinical trials of anti-oxidative stress reagents in patients with cardiovascular disease are contradictory to date, this may be explained by a variety of reasons such as an inadequate study design. More competent anti-oxidative reagents are awaited, and superoxide dismutase mimetics, thiols, xanthine oxidase and NAD(P)H oxidase inhibitors, which regulate intracellular redox reaction and subsequently inhibit oxidative stress, are among promising candidates of future drug developments currently receiving much interest. In this review, the current advances will be highlighted in development of novel anti-oxidative therapeutic approaches against cardiovascular diseases.

Keywords: Angiotensin-converting enzyme (ACE) inhibitor, angiotensin receptor blocker (ARB), diabetes mellitus, endothelium, hypertension, ischemic heart disease, kidney failure, NAD(P)H oxidase, nitric oxide (NO), reactive oxygen species (ROS), redox, reduced glutathione (GSH), superoxide dismutase (SOD), thiol, xanthine oxidase