Health behaviors and endothelial function.

An unhealthy lifestyle, including excess caloric intake, lack of exercise, smoking, and excessive alcohol consumption, increases one's risk of developing cardiovascular disease (CVD). However, the exact mechanisms by which these behaviors influence the development and progression of CVD have yet to be determined. Endothelial function (EF) has been shown to be a potent predictor of CVD, yet the effects of health behaviors on EF are not clear. The literature assessing the role of four health behaviors, obesity (a proxy of excess caloric intake), smoking, physical inactivity, and alcohol consumption, on the development of endothelial dysfunction is reviewed. Potential mechanisms through which these behaviors may influence EF are discussed. Smoking, being overweight or obese, and physical inactivity are all associated with decreased EF. A direct causal relationship between these measures and EF is suggested by the fact that improvements in these behaviors leads to parallel improvements in EF. The influence of alcohol consumption is somewhat more contentious, with some studies indicating a dose-response relationship such that those with greater consumption have poor EF. However, other studies have shown that those who drink moderately have the best EF. Although there is a growing body of literature implicating poor health behaviors in the development of endothelial dysfunction, more work is needed to establish the exact mechanisms by which this occurs. To our knowledge, there are no studies that have assessed the impact of multiple health behaviors or the interaction of health behaviors on EF.