VCAM1 and endothelial dysfunction: Concurrently, endothelial dysfunction, a hallmark of CSVD, is counteracted by DHA through enhanced NO bioavailability via AMPK activation, attenuated expression of adhesion molecules (ICAM-1/VCAM-1), and reduced endothelial lipotoxicity from triglyceride-rich lipoproteins (Yamada et al., 2008; Wu et al., 2012; Arabi et al., 2024).