NOX enzymes have been implicated in the process of atherosclerosis, the build-up of plaque in arteries, through the production of reactive oxygen species (ROS). ROS appears to play a key role in this process via a series of molecular changes that lead to macrophage infiltration in the endothelium and to plaque formation.

More recently NOX1 has been identified as a key driver in the development of atherosclerotic plaques in a model of diabetes (Circulation 2013).

There is also evidence for the involvement of NOX enzymes in cardiac hypertrophy, progression towards heart failure, hypertension and to some extent myocardial infarction, ischemia/reperfusion injury and atrial fibrillation