It is now recognized that obesity is associated with chronic, low-grade systemic vascular inflammation that encompasses the coronary microvasculature and entails impaired angiogenesis, microvascular rarefaction, as well as endothelial dysfunction and impaired vasodilation due to reduced endothelial nitric oxide synthase (eNOS) activity (55–60). Here, NOS3 is linked to obesity due to melanocortin 4 receptor deficiency.