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Endothelial Function

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Disorders of Blood Pressure Regulation

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

Abstract

Endothelium plays a central role in the maintenance of vascular homeostasis. Vascular reactivity tests represent the most widely used methods in the clinical assessment of endothelial function. In the last two decades, many studies have evaluated the endothelium in hypertensive patients, using different techniques. Several methodologies were developed to study microcirculation and macrocirculation, both in coronary and peripheral vascular districts, leading to the demonstration that hypertensive patients are characterized by endothelial dysfunction, caused by a reduced nitric oxide availability secondary to oxidant excess. The assessment of endothelial dysfunction is of importance since a dysfunctional endothelium is an early marker of the development of atherosclerotic changes and can also contribute to cardiovascular events. Several nonpharmacological and pharmacological approaches have been demonstrated to improve or reverse endothelial dysfunction. As concerns the nonpharmacological therapy, antioxidant compounds, such as the flavonoids contained in red wine and chocolate, have been found to ameliorate endothelial function in peripheral large arteries. Among cardiovascular drugs, β-blockers and diuretics are invariably found to have little or no effect on endothelium-dependent vasodilation. On the other side, calcium channel blockers have been consistently shown to reverse impaired endothelium-dependent vasodilation, mainly in the microcirculation, while RAS inhibitors have been shown to ameliorate endothelium-dependent vasodilation in both coronary and peripheral large arteries, but conflicting results have been obtained in the microcirculation. It is conceivable that the therapeutic correction of endothelial dysfunction may lead to an improvement of prognosis in patients with cardiovascular risk factors or cardiovascular disease. However, scant data are available on this topic, and most of the conclusions that can be drawn are highly speculative.

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Author information

Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy

    Rosa Maria Bruno, Agostino Virdis & Stefano Taddei

Authors
  1. Rosa Maria Bruno
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  2. Agostino Virdis
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  3. Stefano Taddei
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Corresponding author

Correspondence to Stefano Taddei .

Editor information

Editors and Affiliations

  1. Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

    Adel E. Berbari

  2. Emeritus Professor of Medicine, University of Milano-Bicocca, Monza, Italy

    Giuseppe Mancia

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Bruno, R.M., Virdis, A., Taddei, S. (2018). Endothelial Function. In: Berbari, A., Mancia, G. (eds) Disorders of Blood Pressure Regulation. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-59918-2_9

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  • DOI: https://doi.org/10.1007/978-3-319-59918-2_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-59917-5

  • Online ISBN: 978-3-319-59918-2

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