ial ▁function , ▁is ▁a ▁hall mark ▁for ▁v asc ular ▁dise ases , ▁and ▁is ▁often ▁regarded ▁as ▁a ▁key ▁early ▁event ▁in ▁the ▁development ▁of ▁a ther os cl eros is . ▁Imp a ired ▁end oth el ial ▁function , ▁causing ▁hy pert ension ▁and ▁th rom b osis , ▁is ▁often ▁seen ▁in ▁patients ▁with ▁coron ary ▁ar tery ▁disease , ▁di ab etes ▁m ell it us , ▁hy pert ension , ▁hyper ch ol est ero lem ia , ▁as ▁well ▁as ▁in ▁sm ok ers . ▁End oth el ial ▁d ys function ▁has ▁also ▁been ▁shown ▁to ▁be ▁predict ive ▁of ▁future ▁ad verse ▁card i ov asc ular ▁events , ▁and ▁is ▁also ▁present ▁in ▁infl am mat ory ▁disease ▁such ▁as ▁r he um ato id ▁ar th rit is ▁and ▁system ic ▁l up us ▁er yth em atos us . ▁▁ ▁End oth el ial ▁d ys function ▁is ▁a ▁result ▁of ▁changes ▁in ▁end oth el ial ▁function . ▁After ▁fat ▁( lip id ) ▁accum ulation ▁and ▁when ▁stim ulated ▁by ▁infl amm ation , ▁end oth el ial ▁cells ▁become ▁activ ated , ▁which ▁is ▁character ized ▁by ▁the ▁expression ▁of ▁mole cules ▁such ▁as ▁E - select in , ▁V C AM - 1 ▁and ▁IC AM - 1 , ▁which ▁stim ulate ▁the ▁ad hes ion ▁of ▁imm une ▁cells . ▁Additionally , ▁trans cription ▁factors , ▁which ▁are ▁subst ances ▁which ▁act ▁to ▁increase ▁the