HEMODYNAMICS play an important role in the focal nature of atherosclerosis. Mounting evidence has demonstrated that fluid shear stress is intimately involved in the biological activities of vascular endothelial cells (ECs). However, the role of neighboring smooth muscle cells (SMCs) in modulating the endothelial phenotype in the presence of shear stress remains undefined. Emerging EC and SMC coculture systems have provided the basis to elucidate the mechanosignal transduction coupling between ECs and SMCs. Hasting et al. (9) as well as Chiu et al. (2‐5) have demonstrated novel transcriptional regulation to support the notion that endothelial functional phenotypes are not only influenced by hemodynamic forces but also by neighboring SMCs. Vascular ECs in resistant arteries are constantly exposed to the dynamic changes of blood flow, namely, hemodynamic forces. These homodynamic forces can be resolved into three components: 1) shear stress, the tangential frictional force acting at the EC surface; 2) hydrostatic pressure, the perpendicular force acting on the vascular wall; and 3) cyclic strain, the circumferential stretch of the vessel wall (6, 7, 11, 13, 17). Emerging lines of evidence have supported the role of shear stress in mechanosignal transduction between vascular ECs and SMCs (3, 9). ECs are subject to fluid shear stress in the presence of neighboring SMCs (Fig. 1). The bidirectional communication between ECs and SMCs influences the homeostasis of the function and structure of the blood vessel wall. As an interface between blood and the vessel wall, ECs sense and respond to hemodynamic forces. EC and SMC coculture systems have elucidated novel transcriptional regulation between ECs and SMCs (4, 9), providing evidence that endothelial functional phenotypes are not only influenced by hemodynamic forces but also by neighboring SMCs (3, 10) (Fig. 2) . The coculture system represents a significant advance over homogeneous culture to assess the molecular mechanisms whereby shear stresses regulate EC function in the presence of SMCs (1, 14, 15). Using the perfused transcapillary coculture model, Remond et al. (15) reported that ECs protect against flow-induced SMC migration and flow-induced EC plasminogen activator inhibitor type 1. Using the parallel plate EC/SMC coculture system, Chiu et al. (4) reported that laminar shear stress significantly inhibits SMC-induced adhesion molecule gene expression. Furthermore, SMCs induce an upregulation of proinflammatory gene expression in ECs that are located in close proximity to SMCs. However, laminar shear stress acts as a negative regulator by regulating NF-B binding sites in the promoters of these inflammatory genes expressed in the presence