Mechanical forces are key regulators of cell function, particularly of cells within the arterial wall that are exposed to the shear stress and pulsatile pressure of flowing blood. The finding by Chang and colleagues in this issue of Clinical Science that cell stretch can up-regulate the expression of hypoxia-inducible factor-1α and vascular endothelial growth factor, which is a key regulator of blood vessel remodelling, provides us with further insight into the mechanisms underlying remodelling at sites of occlusive disease within the cardiovascular system.

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