The effects of statins on endothelium, inflammation and cardioprotection

The advent of HMG-CoA reductase inhibitors (i.e., statins) has greatly impacted the treatment of cardiovascular disease. Statins were originally developed as lipid-lowering drugs to combat high-cholesterol and attenuate coronary artery disease. Wide-ranging clinical and basic science investigations have now suggested that statins may provide beneficial effects outside of reductions in low-density lipoprotein and triglycerides. These cholesterol-independent actions have been found to downregulate vascular inflammation and promote cardioprotection against ischemic disorders and heart failure. Mechanisms of this protection include increases in endothelial nitric oxide synthase activity and a subsequent rise in nitric oxide bioavailability. This review will encompass clinical and basic science research of statin-mediated cardiovascular protection.