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Additionally vitamins C and E down-regulate NADPH oxidase, a major source of ROS in the vascular wall, and up-regulate eNOS, both of these effects lower blood pressure.[46] In this regard, a randomized double-blind clinical trial other than demonstrating a specific association between oxidative-stress-related parameters and blood pressure, documented enhancement of antioxidant status by supplementation with antioxidants vitamins C and E and their hypotensive properties.[47] Combination supplement with vitamin C, vitamin E, beta-carotene, and zinc also resulted in a significant reduction in systolic blood pressure and a nonsignificant reduction in diastolic blood pressure.[48] The diets rich in fruits and vegetables reduce blood pressure in hypertensive and normotensive patients.[49] The modification in diet results in an increase in serum antioxidant capacity and a decrease in malondialdehyde, an in-vitro marker of lipid peroxidation, suggestive of a reduction in oxidative stress.[49,50,51,52,53] In a study, increase of fruit and vegetable intake for a period of 6 months to the diet of hypertensive subjects, increased blood antioxidant capacity and decreased in systolic and diastolic blood pressure.[49] Large clinical trials examining the effects of antioxidants specifically on blood pressure are rare
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