Blockade of the renin-angiotensin system lowers the rate of cardiovascular events in patients at risk for vascular disease and also improves endothelial function but the mechanism remains unclear. HUVECs were stimulated with Ang II (100 nM). Ang II produced a 2-fold increase in O2- production, which was measured by lucigenin-enhanced chemiluminescence. This increase was blocked by NAD(P)H oxidase inhibitor DPI, but not by eNOS inhibitor L-NAME. Ang II increased monocyte adhesion to ECs by 4.5-fold, and this increase was blocked by candesartan (AT1 receptor antagonist), DPI, L-NAME, wortmannin (PI3K inhibitor), dominant negative-AKT, and p22phox siRNA. Dominant active-AKT increased adhesion by 1.5-fold. Our findings indicate that the simultaneous activation by Ang II of eNOS and NAD(P)H oxidase leads to endothelial activation. This process can partially explain the therapeutic benefits of reducing the action of Ang II.

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