Malfunctions
Various risk factors such as arterial hypertension, increased cholesterol levels and especially nicotine consumption seriously alter the function of the intact endothelium. One speaks then of an endothelial dysfunction. For example, oxidative stress can alter the nitric oxide mechanism and highly toxic metabolites are formed which can damage the endothelium.
Endothelial damage is the basis for the development of arteriosclerosis. These are pathological wall changes, especially of elastic and larger arteries. Atheromatous plaques, an accumulation of invaded lipids, cholesterol and mast cells known as foam cells, form at the wall injuries.
This leads to a narrowing of the vascular lumen (stenosis) and reduced blood flow (ischemia) in the following tissue. There is then a risk that necrosis develops (infarction), which can have life-threatening consequences.