**3. Effect of statins on the thickness of the intima-media complex**

Another important endpoint for determining the effectiveness of statins is the thickness of the intima-media complex, a clinically significant marker of cardiovascular disease. It is noted that the thickness of the intima-media complex in children depends on age, gender and LDL cholesterol level [16]. In children with familial hypercholesterolemia, a much faster increase in this parameter with age was found than in healthy brothers and sisters [17]. Currently, there is a number of studies demonstrating the effect of statins on reducing the thickness of the intima-media complex. M.J. Braamskamp et al. [18] found that in the case of initiation of statin therapy in familial hypercholesterolemia from the age of 12 years, the thickening of the intima-media complex in children occurs more slowly than in peers with familial hypercholesterolemia who do not take statins. The authors concluded that early initiation of statin treatment can delay atherosclerotic changes in the vessels in adolescents and young adults [18]. Statin therapy also has a positive effect on markers of atherosclerosis such as flow-dependent vasodilation. In a study by S. De Jongh et al. (2002) [19], it was found that against the background of 28-week treatment with simvastatin, the flow-dependent vasodilation significantly improved by an average of 4% in children with heterozygous familial hypercholesterolemia compared with that in healthy peers who received placebo.
