Nitric oxide and atherosclerosis: possible implications for therapy.

Atherosclerosis and hypercholesterolaemia disturb the endothelium-dependent regulation of the vascular tone by the labile liposoluble radical nitric oxide. This defect predisposes to vasospasm and ischaemia, with anginal pain as a clinical manifestation. It is now appreciated that endothelial dysfunction is an early event in atherogenesis, possibly also involving the microcirculation, in which atherosclerosis does not develop. Furthermore, it is becoming clear that nitric oxide, in addition to regulating vasomotion, might also modulate the progression of the disease process. The latter notion could have therapeutic implications.