Figure 1.

Pathophysiology of endothelial dysfunction. Healthy endothelium maintains a balance between vasodilating, anti-inflammatory, and anti-thrombotic factors on one side and vasoconstricting, inflammatory, and thrombotic factors on the other. In endothelial dysfunction, increased oxidative stress caused by comorbidities tips the balance over to a vasoconstricting, inflammatory, and thrombotic profile. AT2=angiotensin 2, COX=cyclooxygenase, ET=endothelin, NO=nitric oxide, NOX=nicotinamide adenine dinucleotide phosphate oxidase, ONOO⁻=peroxynitrite, Ortho=orthosympathetic nerve activity, PGI₂=prostacyclin, ROS=reactive oxygen species.