Non-pharmacological modification of endothelial function: An important lesson for clinical practice

Abstract

During the last few generations a rapid increase in the prevalence of cardiovascular diseases has been observed. This epidemiologic fact is in a wide range due to endothelial dysfunction. Endothelium, the inner layer of vessel wall, is a crucial structure in the proper functioning of the cardiovascular system. Next to classic cardiovascular risk factors such as diabetes, obesity, atherosclerosis and hypertension, endothelial dysfunction has become understood as one of the most important elements of cardiovascular pathologies, ranging from ischemic heart disease, stroke to carcinogenesis. This has given rise to a crucial need to develop new therapeutic directions aimed at ameliorating the endothelial function. A healthy lifestyle and proper well-balanced diet seem to be even more important than pharmacotherapy. Therefore, non-pharmacological interventions have become bullet points in a list of endothelial-targeted treatment strategies. Currently, several compounds have been studied as candidates for endothelial function improvement. L-arginine supplementation is proved to reduce fat content. It also preferably modifies carbohydrates metabolism and the expression of genes responsible for increased cardiovascular risk. Spirulina increases the expression of endothelial nitric oxide synthase, which ameliorates nitrogen oxide production and leads to a decrease in blood pressure. The beneficial effect of green tea catechins is based mainly on the inactivation of reactive oxygen. Allicin present in garlic shows both antioxidative and anti-inflammatory effects. Probiotics prevent endothelial dysfunction in effect of improved vascular oxidative stress. Physical activity also demonstrates a number of mechanisms that ameliorate endothelial function. The impact of endothelial function in the complex pathology of cardiovascular diseases reflects a number of scientific proofs showing favorable effects of non-pharmacological interventions in endothelial dysfunction treatment.