A DEEP DIVE INTO THE PROCESS OF ATHEROSCLEROSIS
I used to believe it was. I was wrong.
Atherosclerosis is actually not fundamentally an inflammatory disease. Inflammation is part of the process, but it does not begin there, and certainly isn’t necessary for its development in the first place.
Instead, atherosclerosis is primarily a disorder characterized by the penetration and retention of apolipoprotein B (ApoB), the protein that wraps around cholesterol and other lipids to create the lipoproteins that shuttle these fats around your body, in the space under your endothelium (blood vessel lining).
This process begins when ApoB-containing lipoproteins (LDL being the most plentiful and long lasting) enter the endothelial layer, and then become “retained” or stuck and later modified/oxidized, dumping their cholesterol contents out. Some people, unfortunately, have a higher tendency for their lipoproteins to get stuck once they get in there, for various reasons, and that along with differences in the levels floating around in the blood due to genetics and/or lifestyle factors are some of the keys to what gets this issue going more readily in some than others.
This also helps put to rest another misconception which says that oxidized LDL from the bloodstream is the only type that starts the process. Not true, as normal/native LDL is often involved.
There is still more to learn, but one crucial factor, possibly more than anything else, is that this process of lipoprotein penetration into the endothelium can simply be a result of concentration and time. In other words, whoever you are and whatever other factors may also be involved, how high your apoB is, and for how long, is absolutely crucial. This is why getting checked NOW is so important.
Note- You do not need a damaged or dysfunctional endothelium for this to happen, though this can significantly worsen the problem once it’s started.
LDL/apoB penetration and retention in the lining can then incite the stage of an inflammatory reaction, as the body’s white blood cells enter the area to try and clean things up, a process also impacted by many other potentially controllable factors. If this process gets overwhelmed, inflammation gets worse, which intensifies the atherosclerotic process.
Certainly and for many reasons, many other factors like general metabolic health, high blood sugar, high blood pressure, sludgy blood, oxidative stress in the body, high stress, poor tissue repair capacity, etc can all greatly exacerbate this situation and speed things along, but necessary for the problem to begin, they appear not to be.
Test, and don’t guess on what your LDL and apoB levels are, do not wait around until later to work on whatever angles you need to get them down, and let me know if you need help.