Endothelial dysfunction is caused by disrupted balance between endothelium-derived beneficial and harmful factors affecting vascular inflammation, local vascular tone and blood flow and is a key initial pathological event leading to the development of vascular complications in hypertension and diabetes.Our recent studies reveal that bone morphogenic protein-4 (BMP4), a pro-inflammatory gene induced by disturbed flow in the endothelial cells is likely to be an important initiator of endothelial dysfunction as BMP4 impairs endothelium-dependent vasodilatation and causes endothelial cell apoptosis.