Endothelial function and cardiovascular prevention: role of blood lipids, exercise, and other risk factors.
Multifactorial risk factor modification is proven to positively influence morbidity and mortality from both cardiovascular disease and stroke. The vascular endothelium has recently been a focus of interest in cardiovascular prevention. Data suggest that vascular endothelial dysfunction may contribute to the pathophysiology of clinical ischemia, especially angina, myocardial infarction, and sudden death. Endothelial dysfunction includes abnormalities of vasomotor tone (constriction and dilation), balance between fibrinolysis and thrombosis, control of the inflammatory response, and growth of vascular smooth muscle. Cardiovascular prevention interventions have been studied extensively and there are considerable data supporting a beneficial effect on endothelial dysfunction. The interventions that are clearly effective in improving endothelial function are diet and lipid-lowering therapy (especially with statin drugs), use of angiotensin-converting enzyme inhibitors, hormone replacement therapy, vitamin E, and proper physical exercise. Many challenging issues remain unsolved, however, and the endothelium at both the molecular and cellular levels must be further investigated for both research and clinical interests.
Paterick
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Division of Cardiovascular Diseases, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
Fletcher
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GF
D003327:Coronary Disease / Q000209:etiology* / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology*; D006801:Humans; D008055:Lipids / Q000502:physiology*; D012307:Risk Factors
D008055:Lipids