Meal-Induced Oxidative Stress

The target of interventions to reduce cardiovascular events has focused on total (CHOL) and low-density (LDLC) cholesterol levels. Data from the Framingham Heart Study would suggest that 50% of individuals with so-called “normal” LDLC levels (100 mg/dl or 2.6 mmol/L) would have atherosclerosis by age 50 [1]. In the Pravastatin or Atorvastatin Evaluation and Infection Therapy (PROVE-IT), aggressive cholesterol reduction as part of a secondary trial in highrisk patients only prevented 20% of cardiac events [2]. Bayturan et al reported that, even when aggressive treatment was used to lower mean LDLC to 58.4 mg/dl (1.5 mmol/L), plaque volume could be shown to increase in 20% of the subjects [3]. Attempts to explain this residual risk have ranged from triglycerides (TG), high-density lipoprotein cholesterol (HDLC) [4] to non-HDLC [5] and biomarkers of inflammatory stress [6].