Microvascular endothelial dysfunction and inflammation in vascular senescence and disease

Daniel Kasal ^1,2* Viviane Sena ² Andrea Lorenzo ² Eduardo Tibirica ²

• ¹ Rio de Janeiro State University, Rio de Janeiro, Brazil
• ² National Institute of Cardiology - Rua das Laranjeiras, Rio de Janeiro, Rio de Janeiro, Brazil

Cardiovascular disease (CVD) is the main cause of morbidity and mortality in the adult and the elderly, with increasing prevalence worldwide. A growing body of research has focused on the earliest stage of vascular declineendothelial dysfunction (ED) -which at the microvascular level can anticipate in decades the risk for CVD. This review aims to provide a prospect of the literature regarding the development of ED as an indissociable feature of the aging of the cardiovascular system, highlighting the role of inflammation in the process. Vascular aging consists of a lifelong continuum, which starts with cell respiration and its inherent production of reactive oxygen species. Molecular imbalance is followed by cellular epigenetic changes, which modulate immune cells, such as macrophage and lymphocyte subtypes. These mechanisms are influenced by lifestyle habits, which affect inflammation hotspots in organism, such as visceral fat and gut microbiota. The process can ultimately lead to an environment committed to the loss of the physiological functions of endothelial cells. In addition, we discuss lifestyle changes targeting the connection between inflammation and vascular dysfunction. Addressing microvascular ED represents a critical endeavor in order to prevent or delay vascular aging and associated diseases.