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[Prevention and therapy of vascular damage and endothelial dysfunction with hypocholesteremic agents].

Several recent pieces of clinical evidence have demonstrated that reduction of cholesterol levels positively affects outcomes in both primary and secondary prevention of atherosclerotic vascular disease. The mechanism for the beneficial effects of cholesterol-lowering interventions has been attributed to decreased progression or actual regression of plaques as a consequence of reduced circulating LDL concentrations. Other mechanisms can be hypothesized, including a "stabilizing" effect on plaques, which would decrease chances of rupture, and an improvement of endothelial dysfunction, which would slow-down the progression of the disease. This review is aimed at offering an update on such mechanisms. The hypothesis of a direct action of cholesterol-lowering agents, in particular of statins, on endothelial functions, independently of LDL-lowering effects, will be discussed.