Abstract
Endothelial dysfunction is a central pathophysiological process in cardiovascular medicine, implicated in the initiation and progression of diverse cardiovascular diseases (CVD). It is broadly characterized by reduced bioavailability of vasoprotective mediators (particularly nitric oxide [NO]) and a shift toward a proinflammatory, pro-oxidant, and prothrombotic state. This mini-review summarizes the importance of endothelial dysfunction in CVD, covering normal endothelial function and how dysfunction arises through impaired NO signaling, oxidative stress, inflammation, and endothelial NO synthase (eNOS) uncoupling. We highlight its role in atherosclerosis, hypertension, and heart failure, and review current and emerging biomarkers that reflect endothelial health. Therapeutic strategies – ranging from lifestyle modification and established pharmacotherapies to targeted anti-inflammatory and NO – cGMP pathway interventions – are outlined with emphasis on clinical and translational implications. The review concludes by highlighting future directions for endothelial-targeted diagnostics and therapies to improve cardiovascular outcomes.