Targeting vascular (endothelial) dysfunction

• Published in: British journal of pharmacology Vol. 174; no. 12; pp. 1591 - 1619
• Main Authors: Daiber, Andreas, Steven, Sebastian, Weber, Alina, Shuvaev, Vladimir V., Muzykantov, Vladimir R., Laher, Ismail, Li, Huige, Lamas, Santiago, Münzel, Thomas
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.06.2017; John Wiley and Sons Inc
• Subjects: Adipose tissue; Animals; Anti-Inflammatory Agents - pharmacology; Antioxidants; Antioxidants - pharmacology; Arteriosclerosis; Blood cells; Blood circulation; Cardiovascular diseases; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - drug therapy; Endothelium; Endothelium, Vascular - drug effects; Endothelium, Vascular - metabolism; Humans; Inflammation; Inflammation - drug therapy; Inflammation - metabolism; Muscles; Oxidative stress; Oxidative Stress - drug effects; Review; Risk factors; Smooth muscle; Themed Section: Review; Thickness ratio
• ISSN: 0007-1188; 1476-5381
• DOI: 10.1111/bph.13517

Cardiovascular diseases are major contributors to global deaths and disability‐adjusted life years, with hypertension a significant risk factor for all causes of death. The endothelium that lines the inner wall of the vasculature regulates essential haemostatic functions, such as vascular tone, circulation of blood cells, inflammation and platelet activity. Endothelial dysfunction is an early predictor of atherosclerosis and future cardiovascular events. We review the prognostic value of obtaining measurements of endothelial function, the clinical techniques for its determination, the mechanisms leading to endothelial dysfunction and the therapeutic treatment of endothelial dysfunction. Since vascular oxidative stress and inflammation are major determinants of endothelial function, we have also addressed current antioxidant and anti‐inflammatory therapies. In the light of recent data that dispute the prognostic value of endothelial function in healthy human cohorts, we also discuss alternative diagnostic parameters such as vascular stiffness index and intima/media thickness ratio. We also suggest that assessing vascular function, including that of smooth muscle and even perivascular adipose tissue, may be an appropriate parameter for clinical investigations. Linked Articles This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc