Supplementation with antioxidants and its benefit-risk relationship have been largely discussed in the elderly population. We evaluated whether antioxidants supplementation improved the biochemical profile associated with oxidative metabolism in elderly cardiovascular patients. Patients ( ) received daily supplementation with α-TP 400？mg, beta-carotene 40？mg, and vitamin C 1000？mg for 2 months (treatment). Plasma concentrations of alpha-tocopherol (α-TP), β-carotene (βC), ubiquinol-10 (QH-10), glutathione, and thiobarbituric acid reactive substances (TBARS) were determined before and after treatment. Response to treatment was dependent on pretreatment α-TP and βC levels. Increase in α-TP and βC levels was observed only in patients with basal levels <18？μM for α-TP ( ) and <0.30？μM for βC ( ). Ubiquinol-10, glutathione, and TBARS were unaffected by treatment: QH-10 (+57%, , , and N.S.), glutathione (+21%, , , and N.S.), and TBARS (？29%, , , and N.S.). Treatment reduced oxidative metabolism: 5.3% versus 14.6% basal value ( , ). Basal TBARS/α-TP ratio was higher in smokers compared to nonsmokers: 0.11 ± 0.02 versus 0.06 ± 0.01 ( , ). Response to antioxidant supplementation was dependent on basal plasma levels of α-TP and βC. Smoking status was strongly associated with atherosclerotic cardiovascular disease and high TBARS/α-TP ratio (lipid peroxidation). 1. Introduction Atherosclerotic cardiovascular diseases are a major cause of mortality and morbidity in the general population [1]. Numerous studies have focused on the utility of antioxidant supplementation in the treatment of cardiovascular diseases [2]. Yet, whether antioxidant supplementation has any preventive and/or therapeutic value in cardiovascular pathology is still a matter of debate for evidence is inconclusive [3–9]. Observational studies of vitamins C and E, the most prevalent natural antioxidant vitamins, suggest that supplemental use of these vitamins may lower the risk for coronary events [10]. High doses of antioxidants may pose risk due to adverse effects [11]. Advertising and marketing encourage consumption of vitamins supplements regardless of proper indication and supplements are ready available on-the-counter for self-medication. The estimated prevalence of dietary-supplement use among US adults was reported to be 73% not long ago [9]. In some populations, supplements are consumed to enhance general wellbeing following the advice of friends and magazines [12]. Oxidative stress results from the imbalance between oxidative metabolism and antioxidant activity and is involved in the
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