It is now well known that altered hemodynamics can alter the genes that are expressed by diverse vascular cells, which in turn plays a critical role in the ability of a blood vessel to adapt to new biomechanical conditions and governs the natural history of the progression of many types of disease. Fortunately, when taken together, recent advances in molecular and cell biology, in vivo medical imaging, biomechanics, computational mechanics, and computing power provide an unprecedented opportunity to begin to understand such hemodynamic effects on vascular biology, physiology, and pathophysiology. Moreover, with increased understanding will come the promise of improved designs for medical devices and clinical interventions. The goal of this paper, therefore, is to present a new computational framework that brings together recent advances in computational biosolid and biofluid mechanics that can exploit new information on the biology of vascular growth and remodeling as well as in vivo patient-specific medical imaging so as to enable realistic simulations of vascular adaptations, disease progression, and clinical intervention.