eNOS and Oxidative Stress in the Remodeling Heart: a delicate balance

Cardiovascular disease has become the leading cause of death worldwide. Although typically characterized as a major burden in the Western world, heart related diseases are also rapidly expanding in developing countries. In the Netherlands, cardiovascular diseases are responsible for 30% of all deaths and are the main cause of death in woman. Paradoxically, improved treatment of cardiovascular diseases reduced acute mortality but greatly increased the number of patients suffering from insufficient cardiac pump function referred to as heart failure (HF). HF is the final common stage of all cardiac diseases and considerably increases the risk for morbidity and mortality. Moreover, the prevalence (proportion of the population affected by the disease) and incidence (number of new cases in a period of time) are still increasing. With a prevalence of over 23 million globally, HF has become a chronic disease epidemic. Large cohort studies like the Framingham Heart Study, the Rochester Epidemiologic Project in Olmsted County and the Rotterdam Study consistently show that the prevalence of HF is higher in men than in woman and substantially increases with age 6-10 reaching 1% in those 55-64 years of age and 13% in those aged over 75 years in the Rotterdam Study.6 Additionally race appears to play a role in the prevalence of HF as death rates of HF have shown to be higher in black than in white patients.

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