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The magic of nitric oxide: Why is it the secret weapon for maintaining blood vessel vitality?
In today’s life, blood vessel health is getting more and more attention. Studies have shown that endothelial dysfunction is the root cause of many vascular diseases, and nitrogen oxides (NO) are considered to be a key element in maintaining vascular vitality. This article explores the important role nitrogen oxides play in maintaining vascular health and its impact on overall health.
Endothelial dysfunction
Endothelial dysfunction is a systemic pathological condition characterized by reduced availability of nitrogen oxides. The endothelium, as a semipermeable membrane, not only maintains vascular tone, but also regulates oxidative stress by releasing mediators such as nitrogen oxides, prostaglandins, and endothelin.
Endothelial dysfunction is characterized by vasoconstriction, increased vascular permeability, thrombosis, and inflammatory responses, and these pathological states are closely related to the elevation of a series of biomarkers.
This includes biological indicators such as prothrombin time, D-dimer, Von factor, fibrin degradation products and C-reactive protein. The abnormal state of the endothelium triggers a series of adverse consequences, further aggravating the progression of vascular diseases.
Function of nitrogen oxides
The importance of nitrogen oxides in regulating vascular function cannot be ignored. It can inhibit platelet aggregation, inflammatory response and oxidative stress, and can also inhibit the proliferation of vascular smooth muscle cells and the adhesion of white blood cells. One of the hallmarks of endothelial dysfunction is the inability of arteries to dilate adequately, which is often associated with reduced bioavailability of nitrogen oxides.
Studies have shown that supplementation with tetrahydroquinoline (BH4) has a significant effect on improving endothelial function, although the tendency of BH4 to oxidize to BH2 remains a challenge.
Detection and diagnosis
Current testing of coronary arteries involves angiography of the response to vasoactive substances, while peripheral vascular function can be assessed by venous occlusion flowmetry and ultrasonography.
Among non-invasive detection methods, flow-mediated dilation (FMD) has been widely used and is inversely related to the baseline size of intravascular diameter.
The newly launched Itamar Medical's EndoPAT device can non-invasively assess endothelial function by measuring the reactive hyperflow index, with a sensitivity and specificity of 80% and 86% for diagnosing coronary artery disease.
Endothelial Dysfunction and Stents
Many studies have shown that stent implantation is associated with endothelial dysfunction. Although the Sirolimus drug-eluting stent has been favored for its low restenosis rate, further studies have shown that it may exacerbate endothelial dysfunction in humans.
The impact of COVID-19 on endothelial function
With the impact of the COVID-19 epidemic, the manifestations of acute lung injury are also caused by endothelial dysfunction. This is a reminder that the importance of understanding endothelial health cannot be underestimated in epidemic management.
Risk reduction and therapy
Treatment of high blood pressure and high cholesterol can significantly improve endothelial function, especially in patients taking statins, ACE inhibitors, or angiotensin II receptor antagonists. In addition, lifestyle changes, such as smoking cessation, have also been shown to significantly improve endothelial function and reduce the risk of major cardiovascular events.
Finally, maintenance of vascular health is critical to preventing and treating various cardiovascular diseases. Why don't we focus on increasing the bioavailability of nitrogen oxides to promote healthy vascular function?
