Endothelial function in health and disease

Abstract

The endothelium is the principal regulator of vascular homeostasis. The primary functions of the endothelium include regulation of (1) vascular tone, (2) blood coagulation and fibrinolysis, (3) inflammatory responses and (4) vascular wall remodelling. The various functions of the endothelium operate under a delicate balance in order to ensure its optimal function. By orchestrating these functions, the endothelium fulfils an important role in the regulation of the functional integrity of the endothelium and in protecting against potentially harmful stimuli. Therefore, loss of this balance leads to a dysfunctional state in which the vasoconstrictor, prothrombotic and proliferative characteristics of the endothelium predominate; ultimately facilitating the pathophysiology of atherosclerosis. These important endothelial characteristics will be described in detail in this chapter, whilst we also discuss prominent cardiovascular disease risk factors affecting endothelial function.