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Semin Vasc Med 2004; 4(4): 333-346
DOI: 10.1055/s-2004-869590
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Statins and Endothelial Dysfunction

Eric Larose1 , 2 , Peter Ganz1 , 2
  • 1Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts
  • 2Cardiovascular Division, Harvard Medical School, Boston, Massachusetts
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Publication History

Publication Date:
29 April 2005 (online)

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ABSTRACT

The endothelium integrates and modulates critical functions of the arterial wall. As well as regulating vasomotion, it controls inflammation, coagulation, and thrombosis. Many of these actions are mediated through the release of nitric oxide. Endothelial dysfunction is associated with atherosclerosis and its risk factors. It is independently correlated to adverse cardiovascular events, including myocardial infarction, coronary death, and the need for revascularization. 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) protect against cardiovascular death, myocardial ischemia, myocardial infarction, and stroke. Although cholesterol reduction accounts for some of these benefits, others appear to be independent of cholesterol lowering. The endothelium mediates many of these “lipid-dependent” and “lipid-independent” actions of statins. This chapter reviews the effects of statins on endothelial dysfunction. To do so, a brief outline of the biology of the endothelium is a prerequisite. This will be followed by a summary of the advances in vascular research on cholesterol-dependent and cholesterol-independent effects of statins, with a focus on the endothelium. Ultimately, clinical relevance of observations derived from basic biology will be discussed.

KEYWORDS

Endothelial function - atherosclerosis - coronary artery disease - HMG-CoA reductase inhibitors - statins

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Eric LaroseD.V.M. M.D. 

Cardiovascular Division, Brigham and Women's Hospital

75 Francis Street, Tower 3A, Boston, MA 02115