Environmental stressors and the endothelium

Dysfunction of the endothelium, a monolayer of cells in the lumen of all vessels, is found near-universally in the context of cardiovascular risk factors and diseases (CVD). Because of its crucial role in regulating vascular tone, hemostatic functions, inflammation, adhesion, and platelet activity, normalizing endothelial function is an attractive target in therapeutic approaches to CVD with prognostic implications. We will review the mechanisms leading to endothelial dysfunction in response to traditional and novel cardiovascular risk factors noise and air pollution with focus on oxidative stress and inflammation. A cardiac and vasoactive medication might attenuate vascular dysfunction based on the pathophysiology leading to the environment-induced endothelial dysfunction. The most promising approach, however, represents reductions of particulate matter with a diameter ≤2.5µm (PM_2.5) concentrations via improvements in air quality and marked reductions in transportation noise day and night levels as indicated by the World Health Organization (WHO), thereby markedly reducing the cardiovascular burden induced by noise and air pollution.