What causes atherosclerosis over time?

Atherosclerosis is a progressive condition characterized by the buildup of plaques in the arterial walls, which can lead to cardiovascular diseases. The primary factor that contributes to this process over time is the chronic accumulation of low-density lipoprotein (LDL) cholesterol. When there is an excess of LDL in the bloodstream, it can penetrate the artery walls and become oxidized. This oxidation triggers an inflammatory response that attracts immune cells, leading to further plaque formation and buildup.

The process is exacerbated by factors such as inflammation, hypertension, and smoking, which can damage the endothelium (the inner lining of blood vessels) and promote the uptake of LDL into the arterial walls. Over time, this accumulation of LDL cholesterol and other substances forms plaques, potentially narrowing the arteries, restricting blood flow, and increasing the risk of heart attack or stroke.

In contrast, high-density lipoprotein (HDL) cholesterol is often viewed as "good" cholesterol because it helps remove LDL from the bloodstream and transports it to the liver for excretion. Therefore, an accumulation of HDL is not linked to atherosclerosis. While dietary iron levels and genetic factors can play roles in cardiovascular health, they are not the primary causes of atherosclerosis. Hence, the chronic accumulation