Statins inhibit the production of endothelin-1 and the expression of angiotensin receptor I. Beyond their effects on vasomotor tone, these mediators are involved in leukocyte adhesion, thrombosis, and oxidant generation. Adenosine synthesis by EC is enhanced by statins through inhibition of ecto-5'-nucleotidase endocytosis, resulting in increased activity. The activity of this enzyme is normally increased in response to hypoxia and has been implicated in myocardial ischemic preconditioning.
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