REVIEWS & EDITORIALSAssessment of endothelium-independent vasodilation from methodology to clinical perspectivesMaruhashi, Tatsuyaa; Kihara, Yasukia; Higashi, Yukihitob,cAuthor Information aDepartment of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences bDepartment of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University cDivision of Regeneration and Medicine, Hiroshima University Hospital, Hiroshima, Japan Correspondence to Yukihito Higashi, MD, PhD, FAHA, Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine (RIRBM), Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Tel: +81 82 257 5831; fax: +81 82 257 5831; e-mail: [email protected] Abbreviations: ALDH2, aldehyde dehydrogenase 2; CAD, coronary artery disease; FMD, flow-mediated vasodilation; NID, nitroglycerine-induced vasodilation; NO, nitric oxide; ROS, reactive oxygen species; sGC, soluble guanylyl cyclase; VSMC, vascular smooth muscle cell Received 15 January, 2018 Revised 15 February, 2018 Accepted 11 March, 2018 Journal of Hypertension: July 2018 - Volume 36 - Issue 7 - p 1460-1467 doi: 10.1097/HJH.0000000000001750 Buy Metrics Abstract Vascular response to exogenously administered nitroglycerine, an index of endothelium-independent vasodilation, has been used as a control test for the assessment of endothelium-dependent vasodilation (endothelial function) in humans. However, evidence has been accumulating that not only endothelium-dependent vasodilation but also endothelium-independent vasodilation per se is impaired in individuals with cardiovascular risk factors and cardiovascular disease. Impaired endothelium-independent vasodilation is associated with structural vascular alterations and alterations in vascular smooth muscle cells. Several methods, including assessment of vascular responses to vasoactive agents using angiography in a coronary artery and vascular responses to vasoactive agents using venous occlusion plethysmography and ultrasonography in a peripheral artery, are used to assess endothelium-independent vasodilation in humans. Measurement of endothelium-independent vasodilation is also useful for assessment of atherosclerosis and may be a predictor of future cardiovascular events. In this review, we focus on assessment of endothelium-independent vasodilation from methodology aspects to clinical perspectives. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.