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Table 1 summarizes the spectrum of vascular remodeling and Table 2 shows the clinical conditions involving vascular remodeling.1, 2 A form of vascular remodeling involves changes primarily in luminal dimensions. In this example, active restructuring of the cellular and noncellular components of the vessel wall results in marked changes in luminal dimensions, with relatively small changes in wall thickness. Clinical examples of this form of remodeling include the vascular dilations associated with sustained high blood flow eg, an arteriovenous fistula ; or the cell loss and matrix proteolysis that results in aneurysm formation. Conversely, a reduction of the vascular mass and caliber results from a long-term reduction in blood flow. Indeed, rarefaction of the microcirculation a loss of capillary area ; is another form of vascular remodeling that promotes hypertension and tissue ischemia.3 In response to increased arterial pressure, the vessel structure is altered such that the ratio of the width of the wall to the width of the lumen is elevated by either an increase in muscle mass or rearrangements of cellular and noncellular elements. These changes heighten vascular reactivity, which potentiates the increase in peripheral resistance characteristic of hypertension.4-6 The architecture of the vessel wall is also markedly altered in response to vascular injury. A neointima forms as part of a reparative response to injury that involves thrombosis, migration, proliferation of vascular cells, matrix production, and inflammatory cell infiltration and nexium.

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What are the nutritional, psychological and environmental factors that are important for digestive health? The principle factors that influence gut health are diet, infection, environment, and genetics. Physical fitness and exercise are important for general health. Obesity is increasingly associated with cancer including cancers in the digestive system. Stress aggravates symptoms of digestive system diseases, especially in functional gastrointestinal GI ; disorders. Many changes have occurred over human evolution particularly in the last approximately 150 years: increased calorie intake, increasing salt intake, increased consumption of refined sugar, reduced insoluble fibre intake, and the use of food additives and chemicals. Also since the middle of the last century, the widespread use of antibiotics has altered our "normal bowel flora". Our gut environment has changed dramatically, with potentially serious digestive health consequences. 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