Endothelial Dysfunction as the Common Pathway Linking Obesity, Hypertension and Atherosclerosis
Open accessAbstract
Endothelial dysfunction plays a central role in the pathogenesis of cardiovascular diseases, driven by a complex interplay of oxidative stress, metabolic imbalances, and adipokine dysregulation. Excessive reactive oxygen species reduce nitric oxide bioavailability by impairing endothelial nitric oxide synthase function, leading to vascular inflammation and impaired vasodilation. Adipose tissue-derived hormones such as leptin, adiponectin, and resistin exert opposing effects on vascular homeostasis, influencing inflammation and oxidative stress in obesity and metabolic syndrome. Dyslipidemia, particularly through oxidized LDL, initiates endothelial injury and foam cell formation, accelerating atherosclerosis. Furthermore, hypertension and obesity exacerbate vascular dysfunction by disrupting the balance between vasodilators and vasoconstrictors, enhancing oxidative stress, and altering perivascular adipose tissue function. These interrelated mechanisms contribute to the progression of atherosclerotic cardiovascular disease and diabetic vascular complications. A deeper understanding of these processes is essential for developing targeted interventions to restore endothelial health and reduce cardiometabolic risk.
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Endothelial dysfunction is recognised as an early, potentially reversible stage of cardiovascular disease, particularly in ageing populations with metabolic comorbidities.
“Endothelial dysfunction is now recognised as an early, potentially reversible stage of cardiovascular disease, particularly in ageing populations with metabolic comorbidities [207,208].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [208]
The Conclusions describe endothelial dysfunction as an early event in cardiometabolic disease, and §6.1 reports that treatment can improve endothelial function. The Introduction identifies older adults and people with metabolic risk factors as affected groups, but the paper does not specifically establish that the early, potentially reversible stage is particularly characteristic of ageing people with metabolic comorbidities. The indexed passages provide section labels but no page numbers. (LLM, conf=0.82)
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- Authors
- Młynarska, E., Bojdo, K., Frankenstein, H., Krawiranda, K., Kustosik, N., Lisińska, W., Rysz, J., & Franczyk, B.
- Affiliations
- Medical University of Lodz (PL)
- Corresponding author
- Młynarska, Ewelina
- ORCID
- Venue
- International Journal of Molecular Sciences
- Publisher
- MDPI AG
- Published
- 2025-10-16
- Volume
- 26
- Issue
- 20
- Pages
- 10096
- ISSN
- 1422-0067 (ISSN-L)
- PMC
- PMC12564390
- OpenAlex
- W4415259586
- Cited by
- 87
- References
- 146
- Citations by year
- 2026: 86 · 2025: 1
- FWCI
- 11.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Molecular Sciences (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Keywords
- endothelial dysfunction, obesity, hypertension, atherosclerosis, oxidative stress, nitric oxide bioavailability, endothelial nitric oxide synthase, adipokines, leptin, adiponectin, resistin, metabolic syndrome, dyslipidemia, oxidized LDL, foam cell formation, perivascular adipose tissue, vascular inflammation, diabetic vascular complications, cardiovascular disease pathogenesis
- MeSH terms
- Animals, Endothelium, Vascular, Humans, Hypertension, Obesity, Reactive Oxygen Species, Oxidative Stress, Atherosclerosis, Adipokines
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