Whatever is your answer . It will be far off from the truth .
What causes Atheroscerosis ?
The perception that , circulating lipids directly damage the coronary endothelium is an ill proven concept. Isolated hyperlipidemia rarely leads to full blown Atherosclerois .
If LDL moelcules can penetrate the endothelium , why the circulating LDL at a normal concentration of 130mg/dl fail to do so in vast number of humans as they criss cross the human circulatory system at-least a trillion times every year ? So , there must be something else operating *It requires a high blood pressure, diabetes , smoking or some form of endothelial injury (That includes chronic Inflammation ) for the lipids to enter the sub endothelial planes and start depositing.
The relationship between serum lipids and plaque burden lacks clarity.
* The argument that 130mg LDL is injurious to endothelium while 100mg is not , can easily be disputed !
Dr.S.Venkatesan MD 
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