Krzysztof Jakimów, Jakub Ciesielka, Anna Mazur, Łukasz Ważny, Bożena Gabryel

Cardiovascular drugs preventing endothelial dysfunction

 

2025-12-30

Subject of research. Vascular endothelial dysfunction plays an important role in the pathogenesis of cardiovascular diseases, including atherosclerosis and hypertension. Cardiovascular drugs are an important therapeutic option that allows the maintenance of normal endothelial cell function by preserving the balance between vasodilation and vasoconstriction.

Research objective. The aim of this narrative review is to present the current state of knowledge on the effect of cardiovascular drugs on the prevention of vascular endothelial dysfunction.

Methodology. A literature review was conducted using electronic databases (PubMed, Scopus, and Google Scholar). The search strategy used relevant keywords related to endothelial dysfunction and cardiovascular drugs. Original research, systematic reviews, narrative reviews, and meta‑analyses with full-text availability were included.

Results and discussion. Angiotensin-converting enzyme inhibitors (ramipril and zofenopril), beta-blockers (nebivolol and carvedilol), calcium channel blockers (amlodipine), and statins are among the basic groups of drugs used in the treatment of cardiovascular diseases. Their action is manifested through balancing the endothelial mechanisms that relax blood vessels and those that can cause their contraction. They protect the vascular endothelium through improving the availability of vasodilators derived from the endothelium, have anti-inflammatory and antioxidant effects, downregulate the expression of adhesion molecules, and activate endothelial progenitor cells. Some of these drugs are used to reduce metalloproteinase activity, inhibit low‑density lipoprotein cholesterol oxidation, and lower serum prothrombotic factors.

Conclusions. The introduction of new endothelial protective agents should be an integral part of endothelial-targeted therapeutic strategies, thereby reducing morbidity and mortality associated with cardiovascular disease. Treatment guidelines should take into account the protective effect that cardiovascular drugs have on endothelial cells.

Keywords: nitric oxide, statins, ACE inhibitors, β-blockers, endothelial dysfunction, vascular endothelium, cardiovascular diseases.

© Farm Pol, 2025, 81(6): 359–368