Advanced pulmonary arterial hypertension is characterized by extensive vascular remodeling that is usually resistant to vasodilator therapy. Mevastatin is an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, the rate-limiting step for cholesterol synthesis. HMG-CoA reductase inhibitors have been shown to upregulate the cyclin-dependent kinase inhibitor p27(Kip1) and to block cell proliferation through cholesterol-independent pathways. The aim of this study was to determine the effect of mevastatin on DNA synthesis, cell cycle progression, and cell proliferation in rat pulmonary artery smooth muscle cells ( PASMCs). We found that mevastatin induced G(1) arrest and decreased DNA synthesis in rat PASMCs and did so in association with an increase in both total and cyclin E-bound p27(Kip1). This caused a marked decrease in cyclin E kinase activity, which suggests an important role for p27Kip1 in the ability of mevastatin to induce G(1) arrest. However, in PASMCs lacking functional p27(Kip1), mevastatin still decreased cyclin E kinase activity, caused G(1) arrest, and decreased DNA synthesis. In p27(Kip1)-deficient PASMCs, mevastatin induced a greater reduction of cyclin E protein levels ( to 35% of control) than in wild-type cells ( to 70% of control) and also reduced the phosphorylation of cdk2 on threonine 160. Mevastatin also caused apoptosis in both wild-type and p27(Kip1)-deficient PASMCs and was able to do so at a dose that did not induce cell cycle arrest. These data suggest that HMG-CoA reductase inhibitors can both inhibit cell proliferation and induce apoptosis in PASMCs through p27(Kip1)-independent pathways and may be important therapeutic agents in pulmonary arterial hypertension.