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In the recent review by Martinez-Lemus et al. (10) on the plastic nature of the vascular wall, they hypothesize that a remodeling continuum exists that allows the media to rapidly modify its structural characteristics, specifically through the repositioning of smooth muscle cells (SMC). It was suggested that such a system of remodeling contributes to the active control of vascular diameter and tissue blood flow, both acutely and chronically. Although we agree with the general premise that the vessel wall responds to acute and chronic stimuli such as flow, pressure, and local and circulating vasoactive substances through vascular remodeling, we have concerns regarding some of the mechanisms suggested.
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