Generally speaking, metabolic changes in endothelial cells under disturbed flow in vitro and in vivo include reduced mitochondria mass and function (Chen et al., 2010; Kizhakekuttu et al., 2012), an upregulation of glycolysis via dependence on transcription factor hypoxia inducible factor-1α (HIF-1α) (Feng et al., 2017; Wu et al., 2017), an increase in ROS and advanced glycation end-products (such as in diabetes), and nitric oxide deficiency (Eelen et al., 2015) (such as in atherosclerosis). The gene discussed is HIF1A; the disease is atherosclerosis.