“…[ 106 ] Rotational changes in stretch direction can induce reorientation of ECs to new axes, actin cytoskeletal reorganization, and changes in morphology. [ 107,108 ] Similar to shear stress, physiological CS (5–10%) helps maintain fundamental processes including angiogenic sprouting, matrix remodeling via MMP secretion, growth factor and vasomodulatory secretion, and protection from apoptosis via stretch‐activated ion channel stimulation, integrin engagement, and downstream mechanotransductive signaling. [ 42,109,110 ] However, pathological CS (>20%), caused by hypertension, can result in enhanced ROS and TNF‐α production, increased apoptosis, and imbalanced MMP secretion, ultimately affecting EC patency and permeability.…”