A source of great mortality and morbidity in Europe and North America is cardiovascular disease, atherosclerosis. It is recognized as a chronic inflammatory disease of the intermediate and large arteries characterized by thickening of the arterial wall and is the primary cause of coronary and cerebrovascular disease (Wilson, 2005). Every year it causes 4.35 million deaths in Europe and 35% in the UK. The mortality rate is generally higher in men than in pre-menopausal women. After menopause, a woman's risk is similar to that of a man (George and Johnston, 2010). Clinical studies have confirmed that lipid accumulation, endothelial dysfunction, cell proliferation, alteration of the inflammatory matrix and foam cell formation are characteristics of the early pathogenesis of atherosclerotic disease and that therapies aimed at treating these conditions are beneficial (Varghese et al 2005). . This essay will summarize the development and factors that predispose to atherosclerosis and discuss how understanding cellular and molecular mechanisms has led to new therapies for atherosclerosis. Atherosclerosis is a disease in which plaque builds up inside the arteries. Arteries are blood vessels that carry oxygen-rich blood to the heart and other parts of the body. It develops by the accumulation of excess low-density lipoprotein (LDL) in the arterial wall causing damage to the vascular endothelium which increases the expression of adhesion molecules that attach to monocytes and T cells and decreases the capacity of endothelial cells to release nitric oxide (NO). Monocytes and LDL accumulate at the site of injury, then penetrate the intima where the monocytes differentiate to become macrophages and the...... middle of paper...... Francis Group: London Edited by Joseph LoscalzoSerruys P.W, Gershlick A. H (2005)' Handbook of drug-eluting stents' Taylor and Francis group: OxoniaStancu C and Sima A (2001) Statins: mechanism of action and effects Published in J.Cell.Mol.Med. Vol 5, No 4, 2001 pp. 378-387Varghese Z, Fernando R, Moorhead J. F, Powis S. H and Ruan lipids in renal allografts' Published in Translational Physiology:London,Vaughan C. J, Gotto A. M Jr. and Basson C. T, (2000) 'The evolutionary role of statins in the management of atherosclerosis' Published in the Journal of the American College of Cardiology35:1-10Wilson PWF (2005) Molecular Mechanisms of Atherosclerosis Taylor and Francis Group: London Edited by Joseph Loscalzo