Temporally, the processes of pressure-dependent mechanotransduction invoked to reduce hydrostatic pressure occurs in the order: vasodilation (seconds), increased paracellular permeability (10–20 min), activation of transcellular albumin transport (60 min) and, finally, capillary stress failure.4 Interestingly, stress failure of endothelial cells during heart failure and high-altitude pulmonary edema appears to be a component of mechanotransduction. The gene discussed is ALB; the disease is heart failure.