The vascular endothelium plays a critical role in the preservation of norma
l vessel wall structure and function. In particular, endothelial cells cont
rol vascular permeability, vessel tone, coagulation, fibrinolysis, and infl
ammatory responses. These functions are accomplished by production of a var
iety of biologically active substances. However, endothelial cell-mediated
reactions may also lead to the development of pathological stages within th
e vessel wall. The current review is focused on endothelial cell metabolism
in relationship to the development of atherosclerosis.