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Received Sep 20, 2017; Revised Jan 21, 2018; Accepted Feb 28, 2018
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1. Introduction
Cardiovascular diseases (CVDs) remain as the leading cause of global mortality for the past 15 years. In 2015, CVDs had claimed 17.7 million lives, accounting for approximately 45% of all noncommunicable diseases deaths and 31% of all deaths globally [1]. Atherosclerosis is the core pathological element that underlies CVDs, contributing to over 80% of CVD-related fatalities worldwide [2]; while hypercholesterolemia is one of the most prominent risk factors for developing atherosclerosis [3]. Although hypercholesterolemia is related to excessively elevated levels of circulating total and non-high-density lipoprotein cholesterols in the blood, it is not solely a metabolic disorder of cholesterol homeostasis. Instead, hypercholesterolemia is indispensably associated with exacerbation of oxidative stress and inflammation, which culminates in the impairment of vascular reactivity and progression of atherogenesis [4]. The hypercholesterolemic environment activates major oxidant-producing enzymes including xanthine oxidase, NADPH oxidases (NOX), and myeloperoxidase, resulting in the excessive generation of reactive oxygen species (ROS) and oxidative stress consequently. Oxidative stress abrogates endothelial nitric oxide (NO) availability, uncouples endothelial nitric oxide synthase (eNOS), and enhances the oxidation of entrapped low-density lipoprotein (LDL) within the subendothelial space, thereby eliciting the vascular inflammation response by recruiting monocytes into the tunica intima. The unregulated uptake of oxidized LDL (oxLDL) by differentiated monocytes (macrophages) leads to the formation of foam cells, producing numerous proinflammatory and oxidative stress markers, cytokines, and growth factors, which further aggravate the atherogenic process [4–7].
Improvements in awareness of CVDs, their risk factors, and preventive behaviors have been evident around the world. The appeal in the relationship between diet and health coupled with consumer acceptance for the concept of functional foods, and better understanding of its determinants, has stimulated exponential growth of the global functional food market recently. According to the latest market report, the global cardiovascular health market was valued at USD 8.2 billion in 2016 [8]. Due to the strong correlation between hypercholesterolemia, oxidative stress, and inflammation in the pathogenesis of atherosclerosis, the search for cardioprotective functional food ingredients that possess strong antioxidant and...