Polyphenols, Inflammation, and Cardiovascular Disease
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VASCULAR BIOLOGY (RS ROSENSON, SECTION EDITOR)
Polyphenols, Inflammation, and Cardiovascular Disease Christy C. Tangney & Heather E. Rasmussen
Published online: 20 March 2013 # Springer Science+Business Media New York 2013
Abstract Polyphenols are compounds found in foods such as tea, coffee, cocoa, olive oil, and red wine and have been studied to determine if their intake may modify cardiovascular disease (CVD) risk. Historically, biologic actions of polyphenols have been attributed to antioxidant activities, but recent evidence suggests that immunomodulatory and vasodilatory properties of polyphenols may also contribute to CVD risk reduction. These properties will be discussed, and recent epidemiological evidence and intervention trials will be reviewed. Further identification of polyphenols in foods and accurate assessment of exposures through measurement of biomarkers (i.e., polyphenol metabolites) could provide the needed impetus to examine the impact of polyphenol-rich foods on CVD intermediate outcomes (especially those signifying chronic inflammation) and hard endpoints among high risk patients. Although we have mechanistic insight into how polyphenols may function in CVD risk reduction, further research is needed before definitive recommendations for consumption can be made. Keywords Polyphenols . Inflammation . Olive oil . Flavonoid . Phenolic acids . Flow-mediated vasodilation . Endothelial dysfunction . Cell signaling . Adhesion markers
Introduction Atherosclerosis, the pathological condition often underlying cardiovascular disease (CVD), is a chronic inflammatory This article is part of the Topical Collection on Vascular Biology C. C. Tangney (*) : H. E. Rasmussen Rush University Medical Center, 1700 W Van Buren, Ste 425, Chicago, IL 60612, USA e-mail: [email protected] H. E. Rasmussen e-mail: [email protected]
condition involved in the initiation and perpetuation of atherosclerotic lesions, which may erode or rupture leading to clinical events such as angina, myocardial infarction, or cerebrovascular attack. Because a poor quality diet, smoking, and physical inactivity account for much of modifiable CVD risk, the role of diets rich in bioactive compounds in maintaining or improving cardiovascular health is of utmost interest. As this underlying chronic inflammation plays a key role in development and progression of CVD, bioactive compounds with anti-inflammatory properties such as polyphenols (PPs) is the focus of this review. Polyphenol Classification and Food Sources Polyphenols naturally exist in plants and plant products, including fruits, vegetables, nuts, herbs, cocoa, and tea. Over 500 different PPs exist and are classified based on structure, with the phenolic hydroxyl groups as the common structural feature. Differences in primary aromatic rings, oxidation status, and functional groups delineate the individual PPs. Four classes of PPs comprise the majority of the PPs in foods: flavonoids, lignans, phenolic acids, and stilbenes. Other PPs also exist in foods and are combined into
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