How does hypertension contribute to atherosclerosis?

Hypertension contributes to atherosclerosis primarily by creating stress on blood vessels. High blood pressure exerts excessive force against the walls of arteries, leading to several pathological changes. This constant stress can cause damage to the endothelial lining of blood vessels, making them more susceptible to injury. Once the endothelial cells are compromised, they become less effective at regulating substances that move in and out of the blood vessels, which can lead to the accumulation of lipids and inflammatory cells in the arterial wall. Over time, this process can result in the formation of plaques, a hallmark of atherosclerosis, which narrows the arteries and increases the risk of cardiovascular events.

While the other options mention important concepts related to cardiovascular health, they do not accurately represent the primary mechanism by which hypertension contributes to atherosclerosis. For instance, while hypertension can be associated with changes in cholesterol metabolism, it does not directly cause increased cholesterol levels; rather, it facilitates a conducive environment for atherosclerosis through vascular stress and injury.