CVD is the leading cause of death in industrialized countries and entails increase cost of health care. Primary prevention, early reduction of risk factors and lifestyle modification implies the most significant decrease in cardiovascular disease associated mortality and morbidity. At the level of population strategy, the consumption of vegetables and fruits, including tomatoes might have an influence on the reduction in the risk of cardiovascular diseases mediated by reduction of body mass and lipid profile improvement.
Tomatoes are an important source of bioactive compounds which can be divided into three groups: carotenoids, vitamins, phenols. Standardized tomato extract (STE) comprises of those chemicals in high concentrations which are obtained due to modern technologies. There have been many studies that have shown anti-inflammatory, antioxidant, anti-tumor and endothelium protective properties of carotenoids, the most important fact is that a diet rich in tomatoes may have a beneficial effect on the cardiovascular system by inhibiting platelet aggregation. Inhibiting platelet caused by ADP-, collagen, and arachidonic acid -related aggregation is mediated by decrease of releasing platelet factor 4 (PF4) or via increase of intracellular cAMP concentration. Active chemicals contained in STE may delay the occurrence of atherosclerotic lesions significantly.
Furthermore, recent studies have reported that a standardized extract of tomato has a blood pressure lowering properties due to the inhibitory activity of angiotensin I converting enzyme (ACE). Tomato extract due to the lack of interaction and side effects, and due to the effectiveness confirmed in the research might be an alternative antiplatelet prophylaxis option instead of ASA (acetylsalicylic acid) in primary prevention of cardiovascular disease, especially in those cases where ASA usage is related with risk of side effects.
In hypertensive patients STE may be considered in difficult-to-control hypertension, especially in high-risk group of patient with numerous risk factor, organ damage or comorbidites such as: diabetes mellitus, overweight or obesity. It should be emphasized that, the can be used as an additional therapy to aspirin and other antiplatelet drugs.