Oxidative Stress and Vascular Disease: Insights from Isoprostane Measurement

Over the last 20 years, overwhelming evidence has accumulated indicating that oxidation of lipoproteins plays an important role in the development of atherosclerosis (1). The pathophysiology of atherosclerosis is characterized by two key processes, lipid deposition and inflammation, within the arterial wall, and oxidative stress provides a link between the two (2). Despite general acceptance of the importance of oxidative events in atherosclerosis, clinical trials of antioxidant supplementation have produced disappointing results (3)(4)(5). There may be several explanations for this, including use of inappropriate antioxidants or antioxidant combinations, incorrect doses, insufficient duration of treatment, or failure to initiate treatment sufficiently early in the atherosclerotic process. Alternatively, the apparent association of oxidative stress and atherosclerosis may be an epiphenomenon. In this issue of the Journal, Gross et al. (6) report an association between increased concentrations of circulating F2-isoprostanes and coronary artery calcification (CAC) in healthy young adults participating in the CARDIA study. Plasma F2-isoprostanes were associated with CAC in both men and women independently of conventional cardiovascular risk factors and C-reactive protein. CAC is a strong predictor of vascular events in prospective studies and can be considered as a good intermediate marker of vascular disease. These findings, therefore, confirm an association between oxidative damage and the …