Abstract
Endothelial dysfunction is a well established response to cardiovascular risk factors and precedes the development of atherosclerosis. Endothelial dysfunction is involved in lesion formation by the promotion of both the early and late mechanisms of atherosclerosis including up-regulation of adhesion molecules, increased chemokine secretion and leukocyte adherence, increased cell permeability, enhanced low-density lipoprotein oxidation, platelet activation, cytokine elaboration, and vascular smooth muscle cell proliferation and migration. Endothelial dysfunction is a term that covers diminished production/availability of nitric oxide and/or an imbalance in the relative contribution of endothelium-derived relaxing and contracting factors. Also, when cardiovascular risk factors are treated the endothelial dysfunction is reversed and it is an independent predictor of cardiac events. We review the literature concerning endothelial dysfunction in regard to its pathogenesis, treatment, and outcome.
MeSH terms
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Aging / physiology
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Angiotensin-Converting Enzyme Inhibitors / therapeutic use
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Atherosclerosis / complications
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Atherosclerosis / drug therapy*
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Atherosclerosis / physiopathology*
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Brachial Artery / drug effects
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Brachial Artery / physiopathology
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Cardiovascular Diseases / etiology*
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Cardiovascular Diseases / prevention & control
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Coronary Circulation
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Diabetes Mellitus, Type 1 / complications
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Diabetes Mellitus, Type 1 / physiopathology
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Diabetes Mellitus, Type 2 / complications
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Diabetes Mellitus, Type 2 / physiopathology
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Endothelium, Vascular / physiopathology*
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Humans
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Hypercholesterolemia / complications
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Hypercholesterolemia / physiopathology
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Hyperhomocysteinemia / complications
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Hyperhomocysteinemia / physiopathology
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Hypertension / complications
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Hypertension / physiopathology
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Hypoglycemic Agents / therapeutic use
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Hypolipidemic Agents / therapeutic use
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Kidney Failure, Chronic / physiopathology
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Obesity / complications
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Obesity / physiopathology
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Prognosis
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Risk Factors
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Smoking / physiopathology
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Treatment Outcome
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Vasodilation*
Substances
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Angiotensin-Converting Enzyme Inhibitors
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Hypoglycemic Agents
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Hypolipidemic Agents