Cutaneous Microvascular Responses Are Improved After Cholesterol-Lowering In Patients With Peripheral Vascular Disease And Hypercholesterolaemia

Abstract

High blood cholesterol concentrations and the risk of coronary heart disease are re-lated. It is now known that lowering cholesterol reduces the incidence of ischaemic car-diac events¹. The reasons for this improvement in cardiac function, however, are not clear. Angiographic assessment of coronary blood vessels reveals only slight regression of large vessel atherosclerosis with lipid-lowering therapy.² Studies in vivo have shown that the endothelium is abnormal in the early preclinical stages of atherosclerosis, even before ana-tomical evidence of plaque formation is present³. Damage to the endothelium predisposes to thrombosis, leucocyte adhesion, and proliferation of smooth muscle cells in the arterial will. The endothelium play an important role is the controlling of vascular tone, and it has been suggested that the beneficial effects of cholesterol-lowering may be related to an im-provement in endothelial cell function. Indeed, studies in human coronary blood vessels show lowering cholesterol improves endothelial cell function.⁴