Oxidative stress is believed to be a cause of aging and cardiovascular disorders. In response to inflammation or endothelial cell injury, production of reactive oxygen species (ROS) is enhanced in vascular cells. These changes contribute to the initiation of atherosclerosis. Vascular cells possess anti-oxidant systems to protect against oxidative stress, in addition to the redox system. The redox status of protein thiols is important for cellular functions. The Akt signaling pathway exerts effects on survival and apoptosis, and is regulated by the glutathione (GSH)/glutaredoxin (GRX)-dependent redox system. Sex hormones such as estrogens protect against oxidative stress by protecting the Akt signaling pathway but the physiological role of the extracellular GSH/GRX system has not been clarified, although found an increase in the levels of S-glutathionylated serum proteins in patients with atherosclerosis obliterans. The results suggested that impaired serum redox potential is a marker of the development vascular dysfunction and estrogen has a possible role in the prevention of atherosclerosis. eNOS and its level is regulated by guanosine triphosphate cyclohydrolase 1, a rate-limiting enzyme in BH4 synthesis, and the redox state of BH4. Under oxidative stress, BH4 is oxidized to form 7,8-dihydropterin (BH2) and biopterin, both incapable of eNOS catalysis. The redox regulation of BH4 and BH2 seems clinically important, although, the precise mechanism is not clear 6,7)