When NO production is impaired as occurs when the vascular endothelium becomes damaged or dysfunctional, the following can result:
  • Vasoconstriction (e.g., coronary vasospasm, elevated systemic vascular resistance, hypertension)
  • Platelet aggregation and adhesion leading to thrombosis
  • Upregulation of leukocyte and endothelial adhesion molecules leading to enhanced inflammation
  • Vascular stenosis, or restenosis as occurs following balloon angioplasty and stent placement
  • Increased inflammation and tissue damage mediated by reactive oxygen species such as superoxide anion and hydroxyl radical

There is considerable evidence that the following diseases/conditions are associated with endothelial dysfunction and reduced NO production and/or bioavailability:

  • Hypertension
  • Obesity
  • Dyslipidemias (particularly hypercholesterolemia and hypertriglyceridemia)
  • Diabetes (both type I and II)
  • Heart failure
  • Atherosclerosis, cigarette smoking, aging, and vascular injury