Microvascular Endothelial Dysfunction in Patients with Obesity

  • Agostino VirdisEmail author
  • Stefano Masi
  • Rocchina Colucci
  • Martina Chiriacò
  • Monica Uliana
  • Ilaria Puxeddu
  • Nunzia Bernardini
  • Corrado Blandizzi
  • Stefano Taddei
Hypertension and Obesity (Efrain Reisin, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hypertension and Obesity


Purpose of Review

To examine the state of the art on the pathogenesis of endothelial dysfunction in the microcirculation of patients with obesity, focusing on the complex relationship between the consolidated and the novel mechanisms involved in this alteration.

Recent Findings

Human obesity is associated with vascular endothelial dysfunction, caused by a reduced nitric oxide availability secondary to an enhanced oxidative stress production. Pro-inflammatory cytokine generation, secreted by perivascular adipose tissue, is a major mechanism whereby obesity is associated with a reduced vascular NO availability. Vasculature also represents a source of low-grade inflammation and oxidative stress which contribute to endothelial dysfunction in obese patients. Recently, a direct influence of arginase on endothelial function by reducing nitric oxide availability was demonstrated in small vessels from patients with severe obesity. This effect is modulated by ageing and related to the high levels of vascular oxidative stress.


Oxidative stress, inflammation, and enzymatic pathways are important players in the pathophysiology of obesity-related vascular disease. The identification of new therapeutic approaches able to interfere with these mechanisms will result in more effective prevention of the cardiovascular complications associated with obesity.


Cytokines Endothelium Microcirculation Obesity Oxidative stress 


Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Agostino Virdis
    • 1
    Email author
  • Stefano Masi
    • 1
  • Rocchina Colucci
    • 2
  • Martina Chiriacò
    • 1
  • Monica Uliana
    • 3
  • Ilaria Puxeddu
    • 1
  • Nunzia Bernardini
    • 1
  • Corrado Blandizzi
    • 1
  • Stefano Taddei
    • 1
  1. 1.Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
  2. 2.Department of Pharmaceutical and Pharmacological SciencesUniversity of PadovaPadovaItaly
  3. 3.Internal Medicine 4University Hospital of PisaPisaItaly

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