Endothelial cell dysfunction as a novel therapeutic target in atherosclerosis.

INTRODUCTION: Dysfunction of vessel endothelium is the first step in a complex and multi-faceted process that eventually leads to initiation of the plaque, formation of atherosclerotic lesions and their complications. The extremely fine-regulated endothelium is the gatekeeper of vascular health, and has been the target of a substantial amount of research. AREAS COVERED: This review examines some of the most common associations between therapies of cardiovascular disease and the endothelium, and summarizes the direction of research that may set the stage for one or more interventions targeted to repair damaged and/or dysfunctional endothelium. Expert commentary: Routine treatment of cardiovascular disease has frequently been shown to have a positive effect on the vascular endothelium. The big question - whether the impact is due to a direct pharmacological effect or whether the function of the endothelium improves as a result of a general improvement in the underlying disease state, is still largely unanswered.