Cynara scolymus (artichoke) extracts have been shown to produce various pharmacological effects, such as the inhibition of cholesterol biosynthesis and of LDL oxidation. Endothelial dysfunction represents the first stage of atherosclerotic disease; it is usually evaluated in humans by a non-invasive ultrasound method as brachial flow-mediated vasodilation (FMV) and by the determination of several humoral markers such as vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and E-selectin. The aim of this study was to investigate the effects of dietary supplementation with C. scolymus juice on brachial FMV of hyperlipaemics. Eighteen moderately hyperlipaemic patients and 10 hyperlipaemic patients were studied and matched for age, sex and lipid parameters. All subjects were under isocaloric hypolipidic diet. A basal determination of serum lipids, soluble VCAM-1, ICAM-1, E-selectin and brachial FMV was performed. Thereafter patients were given 20 ml daily of frozen C. scolymus juice. The same parameters were repeated after 6 weeks. After C. scolymus treatment there was an increase of triglycerides and a reduction of total cholesterol and LDL cholesterol. Controls showed a significant decrease in total and LDL cholesterol. After C. scolymus there was a decrease in VCAM-1 and ICAM-1, brachial FMV increased, while controls did not exhibit significant changes in VCAM-1, ICAM-1, E-selectin and brachial FMV. Univariate analysis showed that, in artichoke patients, changes of VCAM-1 and ICAM-1 were significantly related to changes in brachial FMV. The authors concluded that C. scolymus dietary supplementation seems to positively modulate endothelial function in hypercholesterolaemia.