Vascular endothelium actively participates in inflammatory reactions in the majority of chronic respiratory diseases. Smoking is a major risk factor for bronchopulmonary diseases, and it plays an important role in endothelial dysfunction development. Some experiments prove that aggressive pollutants of tobacco smoke (benzopyrene, peroxynitrite, acrolein, cyanides, peroxides, etc.) can cause direct damage to endothelial cells due to expression of adhesion molecules on their surface and intensification of lipid peroxidation. In turn, oxidized lipoproteins in the tunica intima of the vessel work as attractants for chemotaxis of leukocytes and monocytes that start to produce pro-inflammatory cytokines in big amounts. These processes trigger systemic inflammatory response that leads to irreversible thickening of the vessel walls and deterioration of their mechanical properties. Chronic exposure to tobacco smoke and the products of combustion of tobacco leads to chronic system inflammatory reaction, oxidative stress, endothelial dysfunction and morpho-functional damage of target organs. Nowadays, the connection between chronic obstructive pulmonary disease (COPD) and some cardiovascular and cerebrovascular diseases has been well established. Studying the mechanisms of endothelial dysfunction in brain blood vessels of patients with smoking habits and COPD can be very important for preventing acute vascular events.

The review focuses on recent data concerning clinical and functional characteristics of racial and ethnic specifics of cardiovascular remodelling in arterial hypertension, having the importance for individualization of approaches in diagnostics and cardiovascular risk control (CVR). The key attention is paid for the results of investigation on such characteristics in various ethnicity patients living outside the traditional inhabitation, which is especially important for Russia due to significant demographic variety and migrational currents. So the standard algorithms of CVR assessment seem to be due for reconsideration and taking into account novel reclassification mechanisms. Integral indices of CVR, firstly, related to remodelling, and especially the terms of central arterial stiffness, demand for special attention as perspective non-invasive methods of diagnostics with the aim of personified evaluatory CVR mechanisms, incl. ethnicity.

Vasomotor activity of the major and cerebral arteries was studied in mice with chronic obstructive pulmonary disease. Regional differences were revealed in the endothelium-dependent response of arteries. The development of chronic obstructive pulmonary disease was associated with a paradoxical response of the dilatational component of vasoregulation against the background of increased constrictive influences of the vascular endothelium in the major and cerebral vessels.

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