Endothelial dysfunction: a pharmacological approach

Endothelial dysfunction is characterized by a decreased endothelial NO bioavailability and is evidenced by a reduced vasodilatory response to endothelial stimuli. It has been associated with major cardiovascular risk factors (hypercholesterolemia, hypertension, aging, diabetes...). Increasing NO supply, stimulating NO production, preventing NO degradation or substituting NO deficit are pharmacological opportunities which are described to restore NO bioavailability. At present, some drugs such as statins or ACEI have some of these properties. Unfortunately they do not completly prevent endothelial dysfunction. Therefore, new pharmacological tools targeting endothelial dysfunction are needed to improve patient prognosis. Original mechanisms of action within and/or beyond the NO pathway are not yet clinically available but preclinical models of endothelial dysfunction demonstrate new pharmacological opportunities.