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Endothelial function and dysfunction. Part II: Association with cardiovascular risk factors and diseases. A statement by the Working Group on Endothelins and Endothelial Factors of the European Society of Hypertension*

Brunner, Hanspetera; Cockcroft, John Rb; Deanfield, Johnc; Donald, Annc; Ferrannini, Eled,e; Halcox, Julianc; Kiowski, Wolfgangf; Lüscher, Thomas Fg; Mancia, Giuseppeh; Natali, Andread,e; Oliver, James Ji; Pessina, Achille Cj; Rizzoni, Damianok; Rossi, Gian Paoloj; Salvetti, Antonioe; Spieker, Lukas Eg; Taddei, Stefanoe; Webb, David Ji


Dysfunction of the vascular endothelium is a hallmark of most conditions that are associated with atherosclerosis and is therefore held to be an early feature in atherogenesis. However, the mechanisms by which endothelial dysfunction occurs in smoking, dyslipidaemia, hyperhomocysteinaemia, diabetes mellitus, arterial hypertension, cerebrovascular diseases, coronary artery disease and heart failure are complex and heterogeneous. Recent data indicate that endothelial dysfunction is often associated with erectile dysfunction, which can precede and predict cardiovascular disease in men. This paper will provide a concise overview of the mechanisms causing endothelial dysfunction in the different cardiovascular risk factors and disease conditions, and of the impact of the intervention measures and treatments.

aDivision of Cardiology, University Hospital, Basel, Switzerland

bDepartment of Cardiology, Wales Heart Research Institute, University of Wales College of Medicine, Heath Park, Cardiff

cVascular Physiology Unit, Institute of Child Health and Great Ormond Street Hospital NHS Trust, London, UK

dMetabolism Unit, C.N.R. Institute of Clinical Physiology

eDepartment of Internal Medicine, University of Pisa, Pisa, Italy

fCardiovascular Centre and Foundation, Zürich, Switzerland

gCardiovascular Centre, Cardiology, University Hospital, Zürich, Switzerland

hClinica Medica, University of Milano-Bicocca, Ospedale S. Gerardo dei Tintori, Monza, Italy

iClinical Pharmacology Unit and Research Centre, University of Edinburgh, Western General Hospital, Edinburgh, UK

jDMCS-Clinica Medica 4, University Hospital Padova, Padova, Italy

kInternal Medicine, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy

Received 12 July, 2004

Revised 7 September, 2004

Accepted 8 September, 2004

Correspondence and requests for reprints to Prof. Gian Paolo Rossi, MD, FACC, FAHA, Department of Clinical and Experimental Medicine, Clinica Medica 4, University Hospital, via Giustiniani 2, 35126 Padova, Italy. Tel: +39 (0)49 821 3304 or 2279; fax: +39 49 875 4179; e-mail:

*All authors have contributed equally to this manuscript.

© 2005 Lippincott Williams & Wilkins, Inc.