Objective-We examined the inhibitory mechanisms of fluvastatin on FBS-induced vascular hypertrophy assessed by organ-cultured rat tail artery. Methods and Results-After 5 days of culture with 10% FBS, hyperplastic morphological changes in the media layer were induced. Treatment with 1 mol/L fluvastatin significantly inhibited these changes. In the FBS-cultured arteries, the protein expression ratio of ␣-actin/-actin was significantly decreased, indicating the change to synthetic phenotype. Fluvastatin restored the decreased expression ratio, and the addition of mevalonate (100 mol/L) suppressed this recovery. In accordance with the synthetic morphological changes, the absolute force of contractions induced by stimuli was decreased. Fluvastatin treatment also restored the decreased contractility, and the addition of mevalonate suppressed this recovery. In the arteries cultured with FBS, extracellular signal-regulated kinase 1 and 2 (ERK1/2) and p38 mitogen-activated protein kinase (p38MAPK) phosphorylation were significantly increased. Fluvastatin inhibited these phosphorylations, and mevalonate prevented the action of fluvastatin. Key Words: fluvastatin Ⅲ mevalonate Ⅲ organ culture Ⅲ smooth muscle hypertrophy Ⅲ phenotypic modulation 3 -Hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA) reductase inhibitors, statins, are drugs that decrease the plasma lipid concentration by inhibiting HMG-CoA reductase, a ratelimiting enzyme for the cholesterol biosynthesis, in hepatic cells. 1 In addition, their ability to reduce cholesterol synthesis, which is linked to their local hypocholesterolemic properties, helps prevent cardiovascular events, 2 including clinical trials. 3-5 HMG-CoA reductase intracellularly metabolizes HMG-CoA to mevalonic acid, which is the precursor of numerous bioactive metabolites, such as farnesyl pyrophosphate and geranylgeranyl pyrophosphate. Therefore, statins can potentially have pleiotropic effects on vascular physiology by inhibiting HMG-CoA reductase apart from their blood lipid-lowering effects. 6 -12 For instance, statins can interfere with formation of atherosclerotic lesions through the mechanisms modifying endothelial function, vasomotor function, inflammatory responses, plaque stability, and vascular smooth muscle cell (VSMC) proliferation. 8,11,13,14 VSMC proliferation is a central event in the pathogenesis of vascular lesions such as atherosclerosis, postangioplasty restenosis, or transplant arteriosclerosis. 15,16 Hypercholesterolemia, modified lipids, lipoproteins, hypertension, and infection promote vascular inflammation, which induces vascular hyperplastic responses with VSMC proliferation. It has also been well established that many immune reactive cells such as T cells and macrophages and nonimmune cells such as endothelial cells produce inflammatory cytokines, chemokines, and growth factors to change phenotype modulation for synthetic state and to proliferate VSMCs. 14 In hyperplastic vascular lesions, VSMC phenotype modulates from a contractile phenotype to a synthetic phenotyp...