Lifestyle Choices and Endothelial Function: Risk and Relevance

Abstract

Cardiovascular disease remains the leading cause of death and disability in industrialized nations. The risk of cardiovascular disease is significantly reduced by lifestyle choices that promote cardiovascular health. Epidemiological data demonstrate that poor dietary choices, lack of exercise, smoking, obesity, stress, and pollution all increase cardiovascular risk. Poor habits and choices also have been shown to have adverse effects on vascular endothelial homeostasis leading to the development of endothelial dysfunction. Endothelial dysfunction includes broad regulatory changes leading to the expression of a vasoconstrictive, pro-thrombotic, and pro-inflammatory phenotype of the vascular endothelium. Interest in assessing lifestyle interventions as they relate to endothelial function has been encouraged by data demonstrating that measurements of endothelial function in easily accessible vascular beds such as the brachial artery correlate with risk for future cardiovascular events. Given the logistical difficulties and costs of performing large scale clinical trials assessing the ability of many lifestyle interventions designed to reduce cardiovascular risk, employing measures of endothelial function as a surrogate outcome for cardiovascular risk has allowed researchers to determine the biological plausibility of epidemiological data in this area with smaller studies. Newer study techniques, including genomic methodologies, now allow for better delineation of the mechanisms by which lifestyle choices affect the vascular endothelium and of the role of genetic variation in modifying these effects. This review discusses the effects of lifestyle choices on vascular endothelial function, the role and relevance of using studies that assess endothelial function in assessing cardiovascular risk, and future research directions in this area.

Early postmenopausal women with cardiovascular risk factors improve microvascular dysfunction after acute estradiol administration

“…In advanced atherosclerotic lesions, the reduced number 4 or methylation of endothelial estrogen receptors (ERs) modifies their expression and biological role, 5 pointing to the need for studies designed to identify PMW who might benefit or be at risk from HT. 6 Endothelial dysfunction, the first vascular wall atherosclerotic change, is considered the earliest predictor of clinical CV disease, 7,8 and it is known to occur in initial phases of arterial hypertension, diabetes mellitus, and even prediabetic stages such as impaired fasting glucose or insulin resistance. 9 A reasonable contingent of Breal life[ women treated in general practice reaches menopause with these CV risk factors: depending on ethnicity, 29% to 49% of 40-to 59-year-old American women are hypertensive 10 and 8.7% to 11.5% of 40-to 59-year-old American adults are diabetic.…”

Healthy and Adverse Effects of Plant-Derived Functional Metabolites: The Need of Revealing their Content and Bioactivity in a Complex Food Matrix

“…The consumption of the omega-3 fatty acids EPA and DHA by adults is strongly correlated with reduced risk of cardiovascular disease (Lavie et al, 2009; Wang and Widlansky, 2009). They possess anti-inflammatory effects as well as being cardioprotective including anti-arrhythmic, anti-thrombotic, they lower the blood pressure, improve the endothelial function, and slow down the growth of atherosclerotic plaque; furthermore, they have antibiotic-like effects (Desbois et al, 2009).…”

Postprandial Lipid Metabolism: The Missing Link Between Life-Style Habits and the Increasing Incidence of Metabolic Diseases in Western Countries?~!2009-09-30~!2010-01-26~!2010-03-30~!

“…Despite the grim statistics outlined above, it is increasingly clear that the risk of CVD can be significantly reduced by relatively easily achievable lifestyle changes, such as switching to a healthier diet, higher in fruit, vegetable and fiber and lower in fat and digestible carbohydrate, increasing exercise and stopping smoking [3]. Postprandial lipemia is now recognised as a risk factor for atherosclerosis, a major cause of CVD (see below), and strong evidence indicates that it is influenced not only by the amount and type of fat consumed, but also by other lifestyle factors such dietary intake of protein, fibre and micronutrients as well as by exercise, alcohol consumption and smoking [4,5] .…”