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To the Editor:Hypercholesterolemia represents a major cardiovascular risk factor because of its ability to promote and sustain proatherogenic inflammation of vascular wall.1 A reduction of number and activity of bone marrow–derived endothelial progenitor cells (EPCs) could participate in the development of vascular damage in hypercholesterolemic patients.2 Indeed, EPCs serve as a cellular reservoir to replace dysfunctional endothelium and to form a cellular patch at the site of denuding injury.3 According to this, the level of circulating EPCs predicts the occurrence of cardiovascular events and death from cardiovascular causes.4 Nonpharmacological treatment represents the first-line approach to primary prevention in hypercholesterolemia because of its effects on lipid profile and cardiovascular outcomes.5 Despite the wealth of evidence derived from epidemiological and interventional trials, there is limited understanding of the underlying molecular mechanisms. To clarify this topic, we evaluated whether or not changes in dietary habits, alone or in association with regular physical activity, were able to affect the number of circulating EPCs in patients with isolated hypercholesterolemia.We studied 38 never-treated hypercholesterolemic patients (LDL cholesterol between 4.1 …

Nonpharmacological Treatment of Hypercholesterolemia Increases Circulating Endothelial Progenitor Cell Population in Adults