Endothelial Dysfunction and Its Implications for the Pathophysiology of Cardiovascular, Renal, and Metabolic Diseases

Abstract

This article aimed to analyze the primary pathophysiological mechanisms of endothelial dysfunction and their implications for the development and progression of cardiovascular, renal, and metabolic diseases, highlighting vascular alterations and their clinical repercussions. It is an integrative literature review—qualitative, descriptive, and exploratory in nature—based on an analysis of scientific publications on the subject, covering studies published between 2016 and 2026, retrieved from the PubMed/MEDLINE, Scientific Electronic Library Online (SciELO), and Virtual Health Library (VHL) databases. The results indicate that endothelial dysfunction is associated with reduced nitric oxide bioavailability, increased oxidative stress, the activation of inflammatory processes, and impaired vascular regulation. In the context of cardiovascular diseases, notable alterations include those related to arterial hypertension, atherosclerosis, and coronary dysfunction. Regarding renal conditions, mechanisms linked to inflammation, the uremic environment, and microcirculatory changes were identified. In the realm of metabolic diseases, associations were observed between hyperglycemia, insulin resistance, obesity, and endothelial impairment. It is concluded that endothelial dysfunction serves as a shared pathophysiological mechanism across various chronic diseases, underscoring the importance of early identification of vascular alterations and the management of risk factors. Nevertheless, further research is required to refine diagnostic methods and develop therapeutic strategies aimed at preserving endothelial function.