HMG-CoA reductase inhibitors: Is the endothelium the main target

Endothelial dysfunction is an early event in atherosclerosis and could be c onsidered a response to the injury induced by major risk factors. There is evidence that endothelial dysfunction is intimately involved in the onset a nd the progression of cardiovascular disease through abnormalities in the p roduction, release or degradation of endothelium-derived factors, mainly ni tric oxide and endothelin 1. Several reports have shown that drugs of the s tatin class could have multiple beneficial effects related to endothelium-m ediated vasoactive, antithrombotic, antiproliferative and anti-inflammatory actions. Thus, the question arises of whether endothelial cells a re the m ain target of statin therapy, in the setting of both hypercholesterolemia a nd normocholesterolemia. Experimental and clinical studies are reported tha t could support this hypothesis. Copyrght (C) 2001 S. Karger AG, Basel.