Endothelial dysfunction causes an imbalance between vasodilation and vasoconstriction. The term, endothelial dysfunction, has been used to refer to altered anticoagulant and anti-inflammatory properties of the endothelium, impaired modulation of vascular growth, and dysregulation of vascular remodeling1. Endothelial dysfunction is tied to an impairment of endothelium-dependent vasorelaxation caused by a loss of nitric oxide (NO) bioactivity in the vessel wall. This endothelial dysfunction has been implicated in many vascular diseases such as atherosclerosis, diabetes, hypertension and more. Impaired endothelium function in the coronary circulation has been found to have prognostic implications in that it predicts adverse cardiovascular events and long-term outcome1.
“Substantial clinical and experimental evidence suggest that both diabetes and insulin resistance cause a combination of endothelial dysfunctions, which may diminish the anti-atherogenic role of the vascular endothelium and accelerate atherosclerosis. Both insulin resistance and endothelial dysfunction appear to precede the development of overt hyperglycemia in patients with type 2 diabetes. Therefore, in patients with diabetes or insulin resistance, endothelial dysfunction may be a critical early target for preventing atherosclerosis and cardiovascular disease”2