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The vascular endothelium is a metabolically active organ system that helps to maintain vascular homeostasis. In addition to being an anatomical barrier that prevents the influx of circulating blood into the vessel wall, the endothelium modulates vascular tone, regulates local cellular growth and the deposition of extracellular matrix, protects the vessel from the potentially harmful consequences of toxic substances and cells that circulate in the blood, and mediates hemostatic, inflammatory, and reparative responses to local injury. Conditions such as hypercholesterolemia, systemic hypertension, diabetes, problems that are caused by smoking, and estrogen deficiency are associated with endothelial dysfunction, which may promote
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