This text proposes a classification for endothelial dysfunction including e
tiological, functional and evolutionary aspects: (I) Etiological classifica
tion: (a) primary or 'genotypic' (homozygote children hemocystinuria carrie
rs, normotensive patients with familial antecedents of essential arterial h
ypertension); (b) secondary or 'phenotypic' (atherosclerosis, coronary arte
ry disease, hypertension, diabetes and others). (II) Functional classificat
ion: (a) 'vasotonic' (cardiovascular diseases, vasospasm and thrombosis); (
b) 'vasoplegic' (distributive shock: sepsis, anaphylaxis, anaphylactoid rea
ctions and vasoplegias related to cardiopulmonary bypass). (III) Evolutiona
ry or prognostic classification: (a) 'reversible endothelial dysfunction' (
more probable of happening in the initial phases of the 'vasoplegic' dysfun
ctions); (b) 'partially reversible endothelium dysfunction' (to include the
idea of improvement or modification without complete reversion as in 'vaso
tonic' dysfunctions associated with the cardiovascular diseases); (c) 'irre
versible endothelial dysfunction' (advanced evolution of the cardiovascular
diseases and sepsis). (C) 2000 Elsevier Science Ireland Ltd. All rights re
served.