Oxidation of low-density lipoprotein (LDL) may be implicated in the development of atherosclerotic disease. Oxidised LDL is taken up more readily by monocyte-derived macrophages than LDL. Antibodies to oxidised LDL are found in atherosclerotic lesions. Increased risk of ischaemic heart disease is associated with a preponderance of small dense LDL particles, which are more susceptible to oxidation. Proatherogenic alterations in cell biochemistry and signalling pathways occur in the presence of LDL and more markedly oxidised LDL. In vitro antioxidants inhibit changes in cell biochemistry, while in vivo, they have been shown to attenuate or reverse development of atherosclerosis.