Pharmacology of vascular endothelium

Sir John Vane named vascular endothelium ‘the maestro of blood circulation’. Recently, ‘the maestro’ has become a target for pharmacotherapy of atherothrombotic and diabetic vasculopathies with well known cardio‐vascular drugs belonging to the families of Angiotensin Converting Enzyme inhibitors, HMG CoA reductase inhibitors or β 1 ‐Adrenoceptor antagonists. These drugs became upgraded to a position of the pleiotropic endothelial drugs. It is not a simple verbal change in the nomenclature. It means that these drugs apart from their well defined mechanisms of action, as indicated in their regular names, in addition they act in an unknown mechanism at the level of vascular endothelium preventing angina, myocardial infarction and stroke. Many biochemical events take place in endothelial cells. I chose for a closer inspection the nitric oxide/prostacyclin defensive system to explain the endothelial pleiotropism of the drugs in question. I tried to examine the validity of this conception according to the general rule: in vitro cognitio sed in vivo veritas .