Antioxidant Therapy in CVD: Hope or Hype

Cardiovascular diseases (CVDs) remain a global health challenge, with oxidative stress playing a crucial role in their pathogenesis. This comprehensive chapter explores the diverse sources of reactive species in cardiovascular cells and the intricate antioxidant defense systems. It delves into the intricate role of oxidative stress in the development of CVDs, emphasising the dynamic nature of the diseases and the challenges indetermining the optimal timing for antioxidant interventions. A significant portion of the chapter focuses on the therapeutic efficacy of vitamins, revealing positive outcomes in experimental models. Vitamins A, B6, C, D, and E exhibit various protective effects, impacting homocysteine levels, lipid peroxidation, and cardiac function. Additionally, flavonoids, a group of polyphenolic compounds, are highlighted for their potential antioxidant effects and cardioprotective mechanisms. This chapter underscores the need for personalized approaches based on individual oxidative status. Mitochondrial-targeted antioxidants emerge as a promising class of therapeutic agents, specifically addressing oxidative stress within the mitochondria. This chapter details two approaches—mitochondria-targeting ligand conjugates and mitochondrial targeting elements to nanocarriers. Clinically used drugs with antioxidant roles, such as statins, evolocumab, metformin, and dapagliflozin, are explored for their multifaceted impact on cardiovascular health. While preclinical studies show promise, the translation of mitochondrial-targeted antioxidants and clinically used drugs into effective clinical strategies requires further exploration. Ongoing research aims to refine formulations, optimize dosages, and assess long-term safety and effectiveness. If successful, these approaches could represent novel and targeted therapeutic strategies for managing oxidative stress-related cardiovascular diseases.