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Updated: Jun 8, 2026

Non-invasive Assessment of Microvascular and Endothelial Function
Published on: January 29, 2013
Vascular endothelial function and hypertension: insights and directions
Kodlipet Dharmashankar1, Michael E Widlansky
1Medical College of Wisconsin, 9200 West Wisconsin Avenue, FEC Suite E5100, Milwaukee, WI 53226, USA.
Insights
High blood pressure (hypertension) and endothelial dysfunction are closely linked, contributing to cardiovascular disease. Understanding their connection may lead to new treatments beyond blood pressure reduction.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Hypertension Research
Background:
- Hypertension is a major global cause of cardiovascular morbidity and mortality.
- Endothelial dysfunction is an early alteration in vascular endothelium, predicting cardiovascular events and risk.
- The interplay between hypertension and endothelial dysfunction is complex and significant.
Purpose of the Study:
- To review recent findings on the mechanisms linking hypertension and endothelial dysfunction.
- To explore the interrelationship between hypertension and endothelial dysfunction.
- To examine how antihypertensive therapies improve vascular homeostasis beyond blood pressure reduction.
Main Methods:
- This is a review article, synthesizing current evidence.
- Focuses on pathophysiologic mechanisms.
- Analyzes findings related to antihypertensive therapy efficacy.
Main Results:
- Hypertension and endothelial dysfunction share intricate pathophysiologic mechanisms.
- Endothelial dysfunction is a precursor to adverse cardiovascular events.
- Antihypertensive therapies may offer benefits beyond lowering blood pressure.
Conclusions:
- Hypertension and endothelial dysfunction are fundamentally interconnected.
- Further research is needed to identify key links for novel interventions.
- Targeting the hypertension-endothelial dysfunction axis could yield new therapeutic strategies.
Abstract:
Hypertension contributes significantly to worldwide cardiovascular morbidity and mortality. Hypertension appears to have a complex association with endothelial dysfunction, a phenotypical alteration of the vascular endothelium that precedes the development of adverse cardiovascular events and portends future cardiovascular risk. This review concentrates on recent findings with respect to the mechanisms of hypertension-associated endothelial dysfunction, the interrelationship between these two entities, and the relationship of the efficacy of antihypertensive therapies to improvements in vascular homeostasis beyond blood pressure reduction. Current evidence suggests that hypertension and endothelial dysfunction are integrally related with respect to pathophysiologic mechanisms. Future studies will need to identify the key connections between hypertension and endothelial dysfunction to allow novel interventions to be designed and promulgated.
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