Endothelial dysfunction is characterized by reduced nitric oxide (NO) bioavailability, increased oxidative stress, and an imbalance in vasodilatory and vasoconstricting substances. It plays a central role in the pathogenesis of various cardiovascular, renal, and metabolic disorders. The table below summarizes key associated diseases and the role of endothelial dysfunction in each.
| Disease / Disorder | Role of Endothelial Dysfunction in Pathogenesis | Notes / Evidence |
| Atherosclerosis | Reduced NO and increased adhesion molecule expression promote leukocyte infiltration and plaque formation. | Endothelial dysfunction is an early marker; flow-mediated dilation tests correlate with risk. |
| Hypertension | Loss of NO-mediated vasodilation increases vascular resistance; increased endothelin-1 promotes constriction. | Common in both primary and secondary hypertension. |
| Coronary Artery Disease | Impaired endothelial regulation contributes to reduced coronary blood flow and plaque instability. | ADMA levels correlate with CAD severity. |
| Heart Failure | Endothelial inflammation and oxidative stress reduce myocardial perfusion and contribute to ventricular remodeling. | Associated with elevated ADMA and impaired flow-mediated dilation. |
| Chronic Kidney Disease | Uremic toxins and oxidative stress impair endothelial function, accelerating vascular calcification. | SDMA strongly correlates with CKD severity. |
| Diabetes Mellitus | Hyperglycemia-induced oxidative stress reduces NO availability and promotes inflammation. | Endothelial dysfunction precedes micro- and macrovascular complications. |
| Stroke | Atherosclerosis and microvascular damage from endothelial dysfunction increase ischemic stroke risk. | Markers like ADMA predict stroke incidence. |
| Peripheral Artery Disease | Reduced NO and increased vasoconstrictors impair blood flow to limbs, worsening ischemia. | Endothelial dysfunction measurement helps assess severity. |
| Erectile Dysfunction | NO deficiency impairs smooth muscle relaxation in penile arteries. | Often shares risk factors with cardiovascular disease. |
| Pulmonary Hypertension | Imbalance between vasodilators (NO, prostacyclin) and vasoconstrictors (endothelin-1) promotes high pulmonary artery pressure. | Endothelial dysfunction is central to disease progression. |