Key result
Combined metabolic and lifestyle therapies improve endothelial function and reduce cardiovascular risk in obesity.
Why the study?
Endothelial dysfunction links obesity to cardiovascular disease and vascular complications, warranting an overview of its molecular mechanisms, diagnostic approaches, and therapeutic strategies.
This review highlights the importance of an integrated diagnostic and therapeutic approach, combining lifestyle modifications and targeted pharmacotherapy, to manage obesity-related endothelial dysfunction and reduce cardiovascular risk.
Answers are grounded in this paper and cite their sources.
May guide integrated obesity care; leaves open confirmation via dedicated RCTs on cardiovascular outcomes.
Endothelial dysfunction is a key mechanism linking obesity, metabolic disturbances, and cardiovascular disease, contributing to the development and progression of atherosclerosis and other vascular complications. This review provides a comprehensive overview of the molecular mechanisms underlying endothelial dysfunction in obesity and discusses current diagnostic approaches and therapeutic strategies aimed at restoring vascular homeostasis. The available evidence indicates that chronic inflammation, oxidative stress, insulin resistance, reduced nitric oxide bioavailability, increased reactive oxygen species production, and dysregulated adipokine signaling play central roles in endothelial impairment. Recent advances in functional vascular assessment, circulating biomarkers, and imaging techniques have improved the early identification of endothelial dysfunction and cardiovascular risk. Current therapeutic strategies include pharmacological agents, such as glucagon-like peptide-1 receptor agonists, sodium-glucose co-transporter 2 inhibitors, metformin, and dipeptidyl peptidase-4 inhibitors, together with lifestyle interventions based on healthy dietary patterns and regular aerobic and resistance exercise. These approaches improve glycemic control, reduce inflammation and oxidative stress, enhance endothelial function, and contribute to cardiovascular protection. Overall, the evidence supports an integrated and personalized management strategy targeting both metabolic and vascular abnormalities to reduce cardiovascular risk and improve long-term clinical outcomes in individuals with obesity.
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Giglio et al. (2026) conducted a review in Obesity and endothelial dysfunction. Pharmacological agents and lifestyle interventions was evaluated. An integrated management strategy targeting both metabolic and vascular abnormalities, including pharmacological agents and lifestyle interventions, improves endothelial function and reduces cardiovascular risk in individuals with obesity.
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