Modulation of endothelial function: Strategy for long-term cardiovascular protection

Properties of the endothelium The endothelium lines all vessels of the body and is the most important communication structure between flowing blood on one hand and the vessel wall, composed of smooth muscle cells and matrix proteins, on the other. Endothelial cells release factors that affect the differentiation and growth of vascular smooth muscle cells; dedifferentiation and subsequent proliferation of vascular smooth muscle cells are important early mechanisms in the pathogenesis of chronic vascular disease. Calcium antagonists and the endothelium Calcium antagonists primarily affect the cellular interactions of endothelial cells, smooth muscle cells, monocytes and thrombocytes, which are important in the early phases of the development of atherosclerosis. The protective effect of calcium antagonists on the vascular system appears to be low at later stages, which include increased matrix formation and central necrosis of atherosclerotic plaques. Conclusion Present evidence indicates that calcium antagonists may be useful prophylactic agents at an early stage in the development of atherosclerotic vascular changes.