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The key to vascular health: Why endothelial dysfunction becomes an invisible killer?
In today's fast-paced life, many people's health is often neglected, especially vascular health. Endothelial dysfunction, as a systemic pathological state, may become a potential "invisible killer" and threaten our cardiovascular health. This article will provide insights into the effects of poor endothelial function and provide possible preventive measures to help readers better understand this condition.
Endothelial dysfunction primarily results from reduced bioavailability of nitric oxide, which results in vasoconstriction, increased vascular permeability, and the ability to ameliorate thrombosis and inflammatory responses.
Physiological role of the endothelium
The endothelium is not only a semipermeable membrane, but also plays an important role in maintaining vascular tone and regulating oxidative stress. A healthy endothelium releases mediators such as nitric oxide, prostaglandins, and endothelins to ensure the smooth functioning of blood vessels. When this function is impaired, a cascade of deleterious effects can occur, including vasoconstriction, vascular leakage, thrombosis, and excessive inflammation.
Atherosclerosis and endothelial dysfunction
The formation of atherosclerosis is closely related to endothelial dysfunction, which often exists before vascular pathological changes. Studies have shown that endothelial dysfunction can promote the adhesion of monocytes and macrophages and increase the penetration of low-density lipoprotein (LDL) into the vessel wall.
Oxidized LDL is an important feature of atherosclerosis. It promotes the formation of foam cells, chemotaxis of monocytes and activation of platelets, ultimately leading to the instability and rupture of atherosclerotic plaques.
The role of nitric oxide
Nitric oxide (NO) plays a vital role in inhibiting platelet aggregation, inflammation, oxidative stress and leukocyte adhesion. When endothelial dysfunction occurs, arteries and arterioles fail to dilate adequately because nitric oxide production is impaired or inactivated by reactive oxygen species. Supplementation with tetrahydrobiopeptide (BH4) has been shown to improve endothelial function in animal studies and clinical trials, but its tendency to oxidize to BH2 remains a significant challenge.
Testing and diagnostic methods
In the coronary circulation, angiography of the coronary arteries' responses to vasoactive substances can be used to monitor endothelial function. In the human peripheral vessels, venous occlusion flow velocimetry and ultrasonography are used to assess endothelial function.
A noninvasive method to measure endothelial function is to measure flow media dilation (% FMD) by brachial artery ultrasound imaging, and von Willebrand factor is an important indicator of endothelial dysfunction.
Relationship between endothelial dysfunction and stents
Many studies have shown a correlation between stent implantation and poor endothelial function. Although sirolimus-releasing stents perform well in preventing in-stent restenosis, subsequent studies have shown that they may impair endothelial function to some extent. In order to inhibit restenosis, the use of drugs such as iopromide-paclitaxel has been proposed.
Prevention and improvement of endothelial function
Treatment of hypertension and hypercholesterolemia may improve endothelial function, particularly in patients taking HMG-CoA reductase inhibitors. In addition, lifestyle changes, such as smoking cessation, have also been shown to improve endothelial function and reduce the risk of major cardiovascular events.
Endothelial dysfunction can be a deadly invisible killer if left unattended. How to improve your endothelial health to ensure the normal functioning of blood vessels will become an important proposition in your life?
