The role of nitric oxide in early atherosclerosis
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- Charakida, M., Deanfield, J.E. & Halcox, J.P.J. Eur J Clin Pharmacol (2006) 62(Suppl 1): 69. doi:10.1007/s00228-005-0007-9
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Atherosclerosis is a chronic inflammatory disease that begins in early life. Atherosclerotic lesions are often detectable in conduit arteries during childhood, and fatty streaks may even arise during fetal development. Endothelial dysfunction, characterized by reduced bioavailability of nitric oxide (NO), promotes the initiation and development of atherosclerotic lesions and contributes to the pathogenesis of plaque instability and thrombosis, the hallmark of acute complications such as myocardial infarction. Exposure of the vascular endothelium of young subjects to conventional as well as novel risk factors for atherosclerosis typically leads to the development of endothelial dysfunction, which can be detected reliably in vivo using noninvasive methods such as ultrasound assessment of brachial artery flow-mediated vasodilatation. Such techniques have contributed greatly to our mechanistic understanding of clinical atherogenesis and may play an important role in the development of strategies for detecting and treating young subjects with increased atherosclerotic risk. In this review, we describe the techniques available for the clinical assessment of NO-dependent vascular function. We also review the determinants of early endothelial dysfunction and describe strategies operating at the level of the endothelium that may be appropriate for risk modification in the young.