Cardiovascular Diseases (CVDs) Cardiovascular diseases are a class of pathologies involving the heart and blood vessels (arteries, capillaries, and veins). They include cardiac diseases, vascular diseases of the brain and kidney, and peripheral arterial disease. Most of the people are dying due to CVDs compared to other diseases [158]. Atherosclerosis Atherosclerosis is a condition commonly referred to as hardening of the arteries. Hyperlipidemia is a major risk factor for atherosclerosis. Elevated levels of oxidized low density lipoprotein (LDL), glucose and free fatty acids are found in patients with atherosclerosis, T2D, and obesity [159]. A profound imbalance of oxidants and antioxidants resulting in oxidative stress is observed in atherosclerosis. In the vessel wall, endothelial cells, smooth muscle cells (SMCs) and macrophages are sources of free radicals [160]. Endothelial dysfunction leads to increased endo- thelial permeability, up regulation of endothelial adhesion molecules, and inflammatory cell infiltration into the arte- rial wall [160]. A substantial data has been shown that ROS are involved in endothelial injury, dysfunction, and lesion progression [161]. The ROS dependent activation of the MMPs results in the degradation of intimal extracellular matrices and promotes smooth muscle cell migration [162]. Cigarette smoking contain large amount of free radicals and may down-regulate key exogenous and endogenous antioixdants such as vitamin-D, carotenes, GPx and SOD and can lead to the dysfunction of monocytes and vascular smooth muscle cells [163]. The proatherogenic agents such as oxidaised lipids, high glucose and cigarette constituents give rise to increased free radical production.
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