| The hypothesis that cardiovascular disease represents a local and general dysfunction of lipid metabolism is now widely accepted. Studies such as the Seven Countries Study (Keys 1980) and later work (Burr 1989, Riemersma 1992) showed both elevated levels of cholesterol and lipoproteins in cardiovascular disease but also an abnormal lipid profile. It was shown that modification of this profile by dietary means could be achieved with beneficial results (Ramirez 1980, Lichtenstein 1999).
Other work (Gey 1991) identified an inverse relation between antioxidant levels and cardiovascular disease and the beneficial results of intervention supplementation trials (Stampfer 1993, Rimm 1993, CHAOS study 1996). The body of this evidence led to the hypothesis (Steinberg 1989) that the major mechanism at work in the pathogenesis of atherosclerosis in man was the oxidative modification of low density lipoprotein (LDL). More recent research has led to modifications to this hypothesis and are reviewed here.
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