Directional endothelial intelligence enables hierarchical prioritization of local mechanical signals

From the report

Nature Cardiovascular Research, Published online: 27 October 2026; doi:10.1038/s44161-026-00902-7In this Comment, we propose the concept of ‘directional endothelial intelligence’ — a framework whereby vascular endothelial cells discriminate between the mechanical forces of flow-induced shear stress and pressure-induced wall stress according to their directional and biomechanical contexts, and hierarchically prioritize vascular responses.