Nitric Oxide: Structure, Pathophysiology and Clinical Significance

Hypertension is the most important modifiable risk factor and, if treated, leads to a reduction in cardiovascular diseases and mortality. A recent perspective emphasizes the central role of nitric oxide bioavailability in the maintenance of healthy vasculature and the regulation of blood pressure. The molecule nitric oxide is very complex with far-reaching implications concerning cardiovascular well-being and pathology. Synthesis of nitric oxide as well as signaling cascades and their regulation thus stands as a critical process in acquiring an understanding regarding its involvement under physiological as well as pathological conditions. With the rapid pace at which NO research is evolving, there are significant gaps in our knowledge that must be filled in if we are ever to take full advantage of its therapeutic potential. Nitric oxide is also considered to be a very important molecule involved in the defense of hypertension through its effects on endothelial function and vascular homeostasis. This review will summarize the current state of knowledge regarding the relationship between NO and hypertension and will attempt to identify those areas where significant lacunae exist and where further research would be appropriate. In addition, focus is directed toward the structure and clinical relevance of NO, describing its functions in endothelial activity, cardiovascular health, and any possible clinical utility.