The impact of Nitric Oxide in Cardiovascular Medicine: Untapped Potential Utility

Carl J. Pepine MD - Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida, USA 

Abstract

The structural integrity and functionality of the endothelium play an important role in atherogenesis and related adverse outcomes. 

Cardiovascular disease risk conditions contribute to oxidative stress, which causes a disruption in the balance between nitric oxide (NO) and reactive oxygen species, with a resulting relative decrease in bioavailable NO and/or the NO-soluble guanylate cyclase cascade in blood vessels. 

This leads to endothelial and vascular smooth muscle cell dysfunction, resulting in increased tone and alterations in cell growth and gene expression that create a prothrombotic, pro inflammatory environment. 

This leads to formation, progression, and destabilisation of atherosclerotic plaques which may result in myocardial infarction, stroke, and cardiovascular death. NO clearly has a critical role in the maintenance and repair of the vasculature, and a decrease in bioavailable NO is linked to adverse outcomes. 

This background provides the rationale for exploring the potential therapeutic role for NO-donating agents in the prevention of adverse cardiovascular outcomes. 

Full transcript available from The American Journal of Medicine