The article discusses the pleiotropic effects of statins, which are drugs primarily used to lower low-density lipoprotein (LDL) cholesterol. These effects, which are often unrelated to the drug's primary mechanism of action, include improving endothelial dysfunction, increasing nitric oxide bioavailability, exhibiting antioxidant properties, inhibiting inflammatory responses, and stabilizing atherosclerotic plaques. The review highlights several key areas where statins have demonstrated beneficial cardiovascular effects: 1. **Improvement of Endothelial Dysfunction**: Statins can improve endothelial function by preventing downregulation of endothelial nitric oxide synthase (eNOS) and enhancing eNOS activity, leading to increased nitric oxide (NO) bioavailability. This improvement is observed both in hypercholesterolemic patients and normocholesterolemic individuals. 2. **Antioxidant Effects**: Statins have direct antioxidant effects on LDL, inhibiting its oxidation and reducing the formation of oxidized LDL, which is a major contributor to atherosclerosis. 3. **Anti-inflammatory Effects**: Statins reduce levels of inflammatory markers such as C-reactive protein (CRP) and adhesion molecules, which are associated with increased risk of cardiovascular events. They also inhibit the production of matrix metalloproteinases (MMPs) by macrophages, which can lead to plaque rupture. 4. **Plaque Stabilization**: Statins contribute to plaque stabilization by reducing the lipid core and inhibiting the uptake of oxidized LDL by macrophages. They also reduce the activity of MMPs and promote apoptosis, which can help prevent plaque rupture. 5. **Additional Effects**: Statins can stimulate the recruitment of endothelial progenitor cells, which play a crucial role in repairing ischemic injury. They also exhibit immunomodulatory effects, potentially reducing the risk of rejection in organ transplantation. Additionally, statins can inhibit myocardial hypertrophy, a risk factor for coronary artery disease and congestive heart failure. Understanding these pleiotropic effects is crucial for optimizing the use of statins in the treatment and prevention of cardiovascular diseases. The article emphasizes that many of these effects operate independently of LDL cholesterol reduction and are rapidly reversible upon discontinuation of the drug. Further research is ongoing to fully establish their role in cardiovascular event prevention.The article discusses the pleiotropic effects of statins, which are drugs primarily used to lower low-density lipoprotein (LDL) cholesterol. These effects, which are often unrelated to the drug's primary mechanism of action, include improving endothelial dysfunction, increasing nitric oxide bioavailability, exhibiting antioxidant properties, inhibiting inflammatory responses, and stabilizing atherosclerotic plaques. The review highlights several key areas where statins have demonstrated beneficial cardiovascular effects: 1. **Improvement of Endothelial Dysfunction**: Statins can improve endothelial function by preventing downregulation of endothelial nitric oxide synthase (eNOS) and enhancing eNOS activity, leading to increased nitric oxide (NO) bioavailability. This improvement is observed both in hypercholesterolemic patients and normocholesterolemic individuals. 2. **Antioxidant Effects**: Statins have direct antioxidant effects on LDL, inhibiting its oxidation and reducing the formation of oxidized LDL, which is a major contributor to atherosclerosis. 3. **Anti-inflammatory Effects**: Statins reduce levels of inflammatory markers such as C-reactive protein (CRP) and adhesion molecules, which are associated with increased risk of cardiovascular events. They also inhibit the production of matrix metalloproteinases (MMPs) by macrophages, which can lead to plaque rupture. 4. **Plaque Stabilization**: Statins contribute to plaque stabilization by reducing the lipid core and inhibiting the uptake of oxidized LDL by macrophages. They also reduce the activity of MMPs and promote apoptosis, which can help prevent plaque rupture. 5. **Additional Effects**: Statins can stimulate the recruitment of endothelial progenitor cells, which play a crucial role in repairing ischemic injury. They also exhibit immunomodulatory effects, potentially reducing the risk of rejection in organ transplantation. Additionally, statins can inhibit myocardial hypertrophy, a risk factor for coronary artery disease and congestive heart failure. Understanding these pleiotropic effects is crucial for optimizing the use of statins in the treatment and prevention of cardiovascular diseases. The article emphasizes that many of these effects operate independently of LDL cholesterol reduction and are rapidly reversible upon discontinuation of the drug. Further research is ongoing to fully establish their role in cardiovascular event prevention.