However, in response to pro-inflammatory and pro-oxidant stressors, such as angiotensin II (angII) infusion, arterial ligation, hyperlipidemic apoE–/– genetic background, aging and a diet rich in fat and sucrose, VSM SirT1 is absolutely essential to prevent maladaptive arterial remodeling that leads to vascular disease, such as atherosclerosis (Gorenne et al., 2013), aortic dissection (Fry et al., 2015), and arterial stiffness (Fry et al., 2016). The gene discussed is SIRT1; the disease is atherosclerosis.