How to Reverse Endothelial Dysfunction

Endothelial dysfunction (ED) is a typical problem in people with acute or stable coronary artery disease. 

But, the dysfunction can also happen in those struggling with chest pain without damaged or diseased major blood vessels. 

Based on a recent study, the prevalence of ED was 33% in patients without coronary artery disease (CAD), 46% in chronic coronary artery problems, and 58% in acute CAD. 

Issues like coronary artery disease, smoking, diabetes, and cardiovascular risk factors are strong predictors of endothelial dysfunction.

So, can you reverse the dysfunction and get your endothelial function back on track? 

We take a closer look at the endothelium and provide you with practical knowledge that can help. Here is a detailed overview of endothelial dysfunction. 

What Is Endothelial Dysfunction?

Before focusing on the dysfunction, it is important to cover the basics. Understanding the relationship between endothelial function and coronary artery disease can offer valuable insight. This can be useful for further research into the dysfunction, stated Eur Heart J for the European Heart Journal

Atherosclerosis is a progressive and chronic vascular disease. The endothelium is an active layer of the blood vessel. 

The endothelium is a very thin membrane that lines the inside of the blood vessels and heart. Endothelial cells let out substances that mitigate vascular contraction and relaxation. 

An endothelial cell can also control platelet adhesion, immune function, and blood clotting. The endothelium creates plenty of factors that regulate:

  • Inflammation
  • Vascular tone
  • Smooth muscle proliferation
  • The adhesion of the moving blood cells

All of these factors play a detrimental role in atherosclerosis and could lead to a cardiovascular event, explains the National Institute of Health. Functional impairment of the endothelium is a typical telltale sign of atherosclerosis. 

Plus, it can happen long before the buildup of cholesterol, fats, and other substances cause the arteries to narrow and block blood flow. When the reactive oxygen species and antioxidant defense system are thrown out of sync, they can lead to dysfunction.

Endothelial dysfunction is recognized by the shift of endothelial function. It causes a proinflammatory state, reduced vasodilation, and prothrombic properties. 

In other words, the dysfunction can promote inflammation and decrease the bioavailability of vasodilators, mainly endothelial nitric oxide.  

Flow-mediated dilation (FMD) refers to the widening of an artery when blood flow increases in the affected artery. To determine FMD, ultrasound is used to measure the widening (dilation) of the brachial artery after a transient period of forearm ischemia. 

Can You Reverse Endothelial Dysfunction?

Current research shows that it may be possible to reverse endothelial dysfunction with specific interventional strategies. 

Both natural and pharmacological options may be beneficial for the arteries and blood. But, future studies are necessary to define their sustainability and long-term effect. 

Some pharmacologic agents can improve vascular endothelial function over six months. Researchers, however, need to further evaluate whether the improvements in the arteries, endothelium, and blood flow can benefit the coronary artery. And provide a clinical benefit. 

Most studies focus on the improvements in endothelial function in the early atherogenic process. Mainly in young adults and children. 

When caught in its early phases, the dysfunction has better odds of being reversible. Early on, if patients were to implement strategies that keep the endothelium in shape, they could experience improved public health. 

How to Reverse Endothelial Dysfunction

Many related articles talk about the endothelium and its link to cardiovascular disease. But, very few focus on how to reverse endothelial dysfunction. 

It is easier for those who understand the vascular endothelium and its impact on nitric oxide to find a solution to the dysfunction. 

Natural Methods

Many experts have talked about the use of food ingredients. This includes dietary supplements and naturally-occurring compounds for endothelial function. 

Research shows some potential of natural products and food to promote vascular and endothelial health. 

Any dysfunction in endothelial health can lead to major cardiovascular disease. It can also affect oxidative stress and drastically impact the endothelial cells. 

For people who are already at risk of heart disease or problems with blood flow, it’s critical to keep the health of the coronary artery in check.

1. Food and Diet

Preclinical reports indicate that foods rich in polyphenols and food-derived products can help activate the pathways in endothelial cells. And promote a better nitric oxide formation. 

These options include red berries, blackberries, and grape-derived products. Other options include cocoa, black tea, green tea, and omega 3 fatty acids. 

The intake of such products showed an improvement in endothelial dysfunction, particularly in humans with cardiovascular disease. 

Even if this review is experimental and limited, it indicates that natural products might have the potential to turn the tide. Predominantly for those at risk of coronary heart disease.

As a result, patients susceptible to heart disease and those needing to stabilize their endothelial function are advised to eat healthy food. 

Foods that help blood circulation include ginger, fatty fish, nuts, walnuts, berries, and garlic

2. Physical Activity

To restore the proper flow of blood, physical activity is also necessary. Exercise can help manage the dysfunction and reduce some of the excess weight. 

3. Quit Smoking

Patients with endothelial problems are also advised to stop smoking. Smoking causes plaque to stack in the blood vessels, making it incredibly difficult for the heart muscle to function. 

4. Manage Stress

Stress is another thing to manage. Stress can profoundly impact the flow of blood and heart muscle. When you ignore it for a long time, it can make the blood stickier and more likely to cause heart issues. 

If you don’t know where to start, consult a specialist. They can advise you to start exercise counseling. Incorporate healthy eating techniques, stress management, and medication if necessary. 

5. Vitamins

The BioMed Research International Journal stated that stimulators of endothelial progenitor cells, tetrahydrobiopterin, antioxidants, and vitamins could also prove useful. Additional reports seem to support these claims. 

The Journal of the American Heart Association stated that vitamin C and vitamin E are essential in normalizing the genetic endothelial function of endothelial nitric oxide synthase (eNOS) and NADPH oxidase activities. 

The antioxidant vitamin C and E can offer an improvement of endothelial function in both animal and human subjects. Vitamin C alone or when combined with E can stimulate nitric oxide generation and curb blood pressure in animals with higher-than-normal blood pressure. 

To top it all off, specific concentrations of vitamin C can reverse endothelial dysfunction in a patient with hypertension and congestive heart failure. 

But, clinical data on vitamin E for the endothelium is mixed. Data indicates that oxidative stress is involved in the manner of development of genetic endothelial dysfunction. 

Experts claim a higher dose of vitamin E compared to vitamin C may be necessary to better the patient’s vascular function and relaxation, and also offer an improved endothelial function. 

These effects were linked with an improved nitric oxide generation. Besides, vitamin C is already considered a key water-soluble antioxidant with the potential to curb oxidative stress. Relying on it for the endothelium can also have its uses. 

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Medical Treatments

Note: We at Ben’s Natural Health favor natural treatment alternatives over drugs. Due to their potential to cause side effects, we don’t like to encourage readers to choose any medication. Unless advised by a medical professional. The information collected here is for educational purposes only. 


For medical treatments, research shows statins and other lipid-lowering agents may help. As well as calcium blockers, angiotensin receptor blockers, L-arginine, erythropoietin, and thiazolidinediones. 

These results were seen in clinical trials. Chronic ACE inhibitors can also improve endothelial function in individuals with cardiovascular risk.

Moreover, an increase in blood flow can stimulate endothelium-dependent vasodilation. It works by amplifying the shear stress on the endothelium. 

mRNA Expression

A 2016 review showed that the comprehensive knowledge of the role of mRNA expression could offer new therapeutic targets and diagnostic biomarkers for managing the endothelial. Mainly the dysfunction associated with increased blood pressure and heart disease complications. 

Aortic Rings

Another report took a closer look at endothelial dysfunction in aortic rings. Researchers found that protein kinase C has a major role in the dysfunction caused by hypertension. Treatment with sodium nitroprusside improves endothelial function in rings with dysfunction. 


Recently more research and studies have popped up about the impact of endothelial dysfunction. Those who want to reverse it should talk to a specialist. Overall, they have two options – natural methods and medical treatment. 

Natural methods are more tailored towards keeping the heart muscle in tip-top shape. This offers patients a viable approach to keeping heart issues at bay. 

Medication takes a more thorough initiative. But, it can only be prescribed by a medical practitioner. 

Other than that, vitamins seem to help. Like vitamin C and vitamin E. Plenty of research support its use for endothelial dysfunction, which makes it worth a try. 

Nevertheless, people shouldn’t try to implement drastic lifestyle changes on their own. They should consult with an expert beforehand. With expert help, you can go a long way and avoid the possibility of some extra health issues.

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  12. Buzinari TC, Oishi JC, De Moraes TF, Vatanabe IP, Selistre-de-Araújo HS, Pestana CR, Rodrigues GJ. Treatment with sodium nitroprusside improves the endothelial function in aortic rings with endothelial dysfunction. Eur J Pharm Sci. 2017. 
  13. Radenković M, Stojanović M, Potpara T, Prostran M. Therapeutic approach in the improvement of endothelial dysfunction: the current state of the art. Biomed Res Int. 2013. 
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