review · International Journal of Molecular Sciences
Endothelial dysfunction serves as an important prognostic indicator for cardiovascular diseases. When the endothelium becomes dysfunctional, it loses the capacity to regulate vascular tone and suppress excessive inflammation. This breakdown disrupts vascular homeostasis and arterial pressure control, potentially causing hypertension. In turn, high blood pressure can trigger endothelial damage due to endothelial cell sensitivity to haemodynamic changes, forming a destructive cycle that damages organs such as the heart and blood vessels. Additionally, sex-specific differences influence endothelial homeostatic functions, vascular tone regulation, and arterial blood pressure variations between women and men. Sex differences also affect how endothelial dysfunction and vascular remodelling develop. Understanding the underlying immunological and metabolic mechanisms, alongside sex-specific variations, is essential for addressing the pathological remodelling of blood vessels linked to arterial hypertension.
Cardiovascular diseases and hypertension represent major global health challenges. By examining how immune and metabolic factors damage the vascular lining, and how these effects differ between men and women, this work clarifies key drivers of vascular disease. Understanding these distinctions helps illuminate why cardiovascular conditions manifest differently across sexes.
This research is early-stage theoretical work focused on reviewing fundamental biological mechanisms. While uncovering these immunological and metabolic pathways could eventually guide biomedical researchers and pharmaceutical developers in targeting vascular remodelling or hypertension, the abstract does not indicate any direct product, applied testing, or clear commercial application pathway.
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Endothelial dysfunction is a strong prognostic factor in predicting the development of cardiovascular diseases. Dysfunctional endothelium loses its homeostatic ability to regulate vascular tone and prevent overactivation of inflammation, leading to vascular dysfunction. These functions are critical for vascular homeostasis and arterial pressure control, the disruption of which may lead to hypertension. Hypertension itself can also cause endothelial dysfunction, as endothelial cells are susceptible to haemodynamic changes. Although it is unclear which of those factors appear first, they create a vicious circle further damaging multiple organs, including the heart and vessels. There are also sex-specific differences in homeostatic functions of the endothelium regarding vessel tone regulation, which may contribute to differences in arterial blood pressure between men and women. Even more importantly, there are sex-differences in the development of endothelial dysfunction and vessel remodelling. Hence, an understanding of the mechanisms of endothelial dysfunction and its contribution to pathological vascular remodelling during hypertension is of critical importance. This review addresses immunological and metabolic aspects in mechanisms of endothelial dysfunction and the resulting mechanisms in vascular remodelling with respect to arterial hypertension, including the potential role of sex-specific differences.
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DOI: 10.3390/ijms252413337
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