According to the latest Global Burden of Disease Study data, non-communicable diseases in general and cardiovascular disease (CVD) in particular are the leading cause of premature death and reduced quality of life. Demographic shifts, unhealthy lifestyles and a higher burden of adverse environmental factors provide an explanation for these findings. The expected growing prevalence of CVD requires enhanced research efforts for identification and characterisation of novel therapeutic targets and strategies. Cardiovascular risk factors including classical (e.g. hypertension, diabetes, hypercholesterolaemia) and non-classical (e.g. environmental stress) factors induce the development of endothelial dysfunction, which is closely associated with oxidant stress and vascular inflammation and results in CVD, particularly in older adults. Most classically successful therapies for CVD display vasoprotective, antioxidant and anti-inflammatory effects, but were originally designed with other therapeutic aims. So far, only a few ‘redox drugs’ are in clinical use and many antioxidant strategies have not met expectations. With the present review, we summarise the actual knowledge on CVD pathomechanisms, with special emphasis on endothelial dysfunction, adverse redox signalling and oxidative stress, highlighting the preclinical and clinical evidence. In addition, we provide a brief overview of established CVD therapies and their relation to endothelial dysfunction and oxidative stress. Finally, we discuss novel strategies for redox-based CVD therapies trying to explain why, despite a clear link between endothelial dysfunction and adverse redox signalling and oxidative stress, redox- and oxidative stress–based therapies have not yet provided a breakthrough in the treatment of endothelial dysfunction and CVD.

根据最新的《全球疾病负担研究》数据，一般性非传染性疾病，尤其是心血管疾病（CVD）是过早死亡和生活质量下降的主要原因。人口变化，不健康的生活方式以及不利的环境因素造成的负担增加，为这些发现提供了解释。预期的CVD患病率不断增长，需要加大研究力度，以鉴定和表征新型治疗靶标和策略。心血管危险因素包括经典因素（例如高血压，糖尿病，高胆固醇血症）和非经典因素（例如环境压力）会诱发内皮功能障碍的发展，内皮功能障碍与氧化应激和血管炎症密切相关，并导致CVD，尤其是在成年人中。CVD最经典的成功疗法显示出血管保护，抗氧化和抗炎作用，但最初是设计用于其他治疗目的的。到目前为止，只有少数几种“氧化还原药物”在临床上使用，许多抗氧化策略还没有达到预期。在本综述中，我们总结了有关CVD发病机制的实际知识，并特别强调了内皮功能障碍，不良的氧化还原信号和氧化应激，突出了临床前和临床证据。另外，我们简要概述了已建立的CVD治疗方法及其与内皮功能障碍和氧化应激的关系。最后，我们讨论了基于氧化还原的CVD治疗的新策略，试图解释为何尽管内皮功能障碍与不良的氧化还原信号传导和氧化应激之间存在明确的联系，