The endothelium can be considered a discrete organ with pathophysiologic implications and as such has both diagnostic and therapeutic possibilities. It is essential for the normal function of the cardiovascular, cerebrovascular, renovascular, and pulmonary vascular system. The endothelium is directly involved in the development and progression of heart disease, stroke, peripheral vascular disease, venous thrombosis, insulin resistance, diabetes, chronic kidney failure, tumor growth, metastases and adverse reproductive outcomes for both the mother and her newborn child. Consequently the endothelium represents an objective biological determinant on which to base new multidisciplinary prevention and health promotion strategies. This summary statement suggests some possible avenues for clinical and public health research.