Congestive heart failure (CHF) after myocardial infarction is associated with diminished endothelial nitric oxide (NO)-mediated vasorelaxation. The 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors have been shown to modulate vascular tone independent of the effects on lipid lowering. We hypothesized that simvastatin restores NO-dependent vasorelaxation with CHF. We found that incubation of the normal rat aorta with 0.1 mM simvastatin for 24 h enhanced ACh-mediated vasorelaxation (P < 0.05). Moreover, simvastatin increased (P < 0.05) endothelial NO synthase (eNOS) protein content by >200% (82.0 +/- 14.0 vs. 21.6 +/- 7.9% II/microg). In cultured endothelial cells, simvastatin (10 and 20 microM) increased eNOS levels by 114.7 +/- 39.9 and 212.0 +/- 75.0% II/microg protein, respectively (both P < 0.05; n = 8). In the rat coronary artery ligation model, oral gavage with 20 mg. kg(-1). day(-1) simvastatin for 3 wk decreased (P < 0.05) mean arterial pressure (121 +/- 20 vs. 96.5 +/- 10.8 mmHg) and left ventricular change in pressure with time (4,500 +/- 700 vs. 4,091 +/- 1,064 mmHg/s, n = 6). Simvastatin reduced (P < 0.05) basal vasoconstriction and improved ACh-mediated vasorelaxation in CHF arterial rings. Inhibition of NO generation by N(G)-nitro-L-arginine methyl ester (100 microM) abolished the ACh-induced vasorelaxation in all rats. In conclusion, chronic treatment of CHF with simvastatin restores endothelial NO-dependent dysfunction and upregulates eNOS protein content in arterial tissue.