Scheme illustrating the actions of intracellular forces on any single endothelial mechanosensor. The transmembrane domain(s) of the mechanosensor is sensing the lipid bilayer lateral pressure. A pulling force from NMMII-generated tension and a pushing force from an actin-based protrusion are also sensed by the mechanosensor, meaning that the energy required for mechanosensor activation can be increased; in this case, the high LSS can be perceived as low LSS, or decreased, in which case the low LSS can be perceived as high LSS. Thus, the interplay of intracellular forces can shift LSS-induced signaling to be either pro-atherogenic or anti-atherogenic. Abbreviations: LSS, laminar shear stress; NMMII, non-muscle myosin II; smACSK, submembrane actin-based cytoskeleton.