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Atherosclerosis, Coronary Artery Disease and Endothelium

One of the foremost leaders of mortality in the US is coronary artery disease (CAD). This disease strikes many older men and women, as a result from the infamous factors of high cholesterol, high blood pressure, and diabetes mellitus, not to mention others. Thanks to research over the last decade, there is more understanding of the role endothelium plays in the coronary system. Instead of having non-active, diffusional barrier-like qualities, as was once thought, the endothelium serves many critically important functions. At the blood vessel walls, the endothelium synthesizes and releases active substances such as nitric oxide and bradykinin, two potent regulators of vessel function. It is found that the physiologic changes in the endothelium affect the mechanisms responsible for atherosclerosis, and progressively in coronary artery disease. The changes that generate these conditions are known as endothelial dysfunction. As we will see, even the smallest factors can play a widespread role in atherogenesis, or the making of degenerative plaques of cholesterol in the inner layer of an artery. Atherosclerosis, a condition increasing with age, is marked by the deposition of lipids into already-present plaques, causing elevate

The endothelium is a “highly dynamic, multifunctional organ whose central role is to respond to changes in stress and blood flow (Jairath, 1999). The endothelium is the largest organ in the body; its total mass is equal to about five human hearts, and surface area about the size of a tennis court. The vascular tone of the blood vessel is maintained by endothelium-released vasoconstrictors and vasodilators. Vasoconstrictors include endothelin, angiotensin II, thromboxane A2, arachidonic acid, prostaglandin H2, thrombin, and nicotine. Vasodilators include nitric oxide, prostacyclin, bradykinin, endothelium-derived hyperpolarizing factor, acetylcholine, serotonin, histamine, and substance P.

d plaques. The inner layer, or endothelium, is the primary site of development of atherosclerosis.

The role of cardiovascular endothelium is of much greater importance than was thought ten years ago. It is a crucial organ to maintain vascular tone and structure, as well as make clotting factors, and mediates the immune response. Applying this to the complex nature of coronary artery disease requires knowledge of a vast and immensely dynamic amount of contributors. One of the fundamental players preventing coronary artery disease is nitric oxide, constantly providing antiatherogenic effects upon the endothelium. The fundamental antagonists such as hypertension, hypercholesterolemia, smoking, and diabetes, all block nitric oxide’s influences while introducing counter effects. For CAD to be avoided in most people, cardiovascular endothelium needs benefits from antiproliferation, antiatherogenesis, antithrombosis, and vasodilation. Indeed, many drugs exist today that are reaped of their benefits. Yet this should combined with diet and lifestyle changes such as smoking cessation and exercise, eating foods with antioxidants, consuming lipid-lowering agents, and in women, consuming estrogen.

Some topics in this essay:
PAI-1 PAI-1, , Sheppard Davies, Angiotensin II, Angiotenin II, VIIIa Platelet, GMP L-arginine, PAI-1 Stimuli, nitric oxide, smooth muscle, et al, II PAI-1, al 1997, pepine et al, pepine et, et al 1997, smooth muscle cell, muscle cell, angiotensin ii, angiotensin-converting enzyme, smooth muscle cells, muscle cells, coronary artery, coronary artery disease,