Cyclooxygenase (COX)-1 and COX-2 are centrally important enzymes within the cardiovascular system with a range of diverse, sometimes opposing, functions. Through the production of thromboxane, COX in platelets is a pro-thrombotic enzyme. By contrast, through the production of prostacyclin, COX in endothelial cells is antithrombotic and in the kidney regulates renal function and blood pressure. Drug inhibition of COX within the cardiovascular system is important for both therapeutic intervention with low dose aspirin and for the manifestation of side effects caused by nonsteroidal anti-inflammatory drugs. This review focuses on the role that COX enzymes and drugs that act on COX pathways have within the cardiovascular system and provides an in-depth resource covering COX biology and pharmacology. The review goes on to consider the role of COX in both discrete cardiovascular locations and in associated organs that contribute to cardiovascular health. We discuss the importance of, and strategies to manipulate, the thromboxane: prostacyclin balance. Finally within this review the authors discuss testable COX-2-hypotheses intended to stimulate debate and facilitate future research and therapeutic opportunities within the field.

环氧合酶 (COX)-1 和 COX-2 是心血管系统中的核心酶，具有多种功能，有时甚至是相反的功能。通过产生血栓素，血小板中的 COX 是一种促血栓形成酶。相比之下，通过产生前列环素，内皮细胞中的 COX 具有抗血栓形成作用，并且在肾脏中调节肾功能和血压。心血管系统内 COX 的药物抑制对于低剂量阿司匹林的治疗干预和非甾体抗炎药引起的副作用的表现都很重要。本综述重点关注 COX 酶和作用于 COX 通路的药物在心血管系统中的作用，并提供涵盖 COX 生物学和药理学的深入资源。该审查继续考虑 COX 在离散心血管位置和有助于心血管健康的相关器官中的作用。我们讨论了血栓素：前列环素平衡的重要性和操作策略。最后，在这篇综述中，作者讨论了可测试的 COX-2 假设，旨在激发辩论并促进该领域未来的研究和治疗机会。