Primary hypercholesterolemia, a metabolic disorder characterized by elevated circulating levels of cholesterol products, mainly low-density lipoproteins, is associated with arteriosclerosis development. Cardiovascular disease, predominantly myocardial infarction and stroke, remains the main cause of death worldwide, with atherosclerosis considered to be the most common underlying pathology. In addition to elevated plasma levels of low-density lipoproteins, low-grade systemic inflammation and endothelial dysfunction seem to be the main drivers of premature atherosclerosis. Here we review current knowledge related to cellular and molecular mechanisms involved in low-grade systemic inflammation and endothelial dysfunction associated with primary hypercholesterolemia. We also discuss the contribution of different inflammatory mediators, immune players and signaling pathways implicated in leukocyte adhesion to the dysfunctional endothelium, a key feature of atherogenesis development. A better understanding of these processes linked to primary hypercholesterolemia should shed new light on cardiovascular disease development and might guide novel and effective therapeutic strategies to impair its progression.

原发性高胆固醇血症是一种代谢紊乱，其特征是胆固醇产物（主要是低密度脂蛋白）的循环水平升高，与动脉硬化的发展有关。心血管疾病，主要是心肌梗塞和中风，仍然是全世界死亡的主要原因，动脉粥样硬化被认为​​是最常见的潜在病理。除了血浆低密度脂蛋白水平升高外，低度全身炎症和内皮功能障碍似乎是过早动脉粥样硬化的主要驱动因素。在这里，我们回顾了与原发性高胆固醇血症相关的低度全身炎症和内皮功能障碍的细胞和分子机制相关的当前知识。我们还讨论了不同炎症介质的贡献，免疫参与者和信号通路涉及白细胞粘附到功能失调的内皮，这是动脉粥样硬化发展的一个关键特征。更好地了解与原发性高胆固醇血症相关的这些过程应该为心血管疾病的发展提供新的思路，并可能指导新的和有效的治疗策略来削弱其进展。