Recipe for Arterial Plaque

What Injures Your Arteries?
Atherosclerosis begins with damage to the very thin, ultrasmooth inner lining of the arteries, the endothelium. Injury can be caused by a number of things, including high blood pressure and toxins (such as nicotine) in the bloodstream. Injury can also be caused by high levels of glucose (blood sugar) and by chemicals produced by excess fat tissue.

The Inflammatory Response
Inflammation is a normal part of your body’s immune reaction to injury. It can be very helpful when it lasts only for the amount of time required to heal the wound or remove the pathogen.

But problems start when inflammation becomes chronic (long term). This may be due to factors such as obesity, smoking, or eating trans fats. When inflammation is chronic, then macrophages and other inflammatory substances continue to accumulate in your body’s tissues over time. Then the inflammation itself can damage the tissues.

Messenger Molecules
In the first phase of inflammation, cytokines—messenger molecules of the immune system—are released by the damaged cells. They signal the immune system to send white blood cells (such as macrophages) to the injured area. As damage to the cells and inflammation continue, more macrophages accumulate at the injured area. The process of plaque formation is underway.

The Role of Cholesterol and Triglycerides
Your immune system will attempt to “patch up” a damaged area in your artery, because if the vessel isn’t repaired then blood will leak out of it. Two of the materials your body uses for this purpose are lipids: cholesterol and triglycerides. They are deposited at the site of damage by LDL-cholesterol, which has the job of circulating in your bloodstream and delivering cholesterol and triglycerides to the cells that need it.

Calcification and Fibrosis
If inflammation continues because of chronic injury to the vessels—for instance, from smoking or untreated high blood pressure—more changes will take place in the damaged tissue of the artery. The next step in plaque formation is fibrosis and calcification. Essentially, a scab forms inside the artery. Calcium precipitates out of the blood and forms solids, calcifying the lipids. Fibrous materials, like collagen, form a cap over the lipid core. Together with other materials, including types of macrophages, they form an atherosclerotic lesion: a plaque. LESS

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Glucose and Vessel Disease
When levels of glucose in the bloodstream are too high, glucose acts as a toxin to the cells of the endothelium. Refined carbohydrates, like those found in white flour and sugar, are very quickly metabolized by your body. They are converted into glucose, which rapidly enters your bloodstream. Muscle cells and some other types of cells in your body require insulin to admit glucose into their interiors. But the endothelial cells lining your arteries have no protection against high levels of blood glucose, because they don’t require insulin to admit it. The glucose penetrates the endothelial cells directly.

How Glucose Poisons Cells
High levels of glucose are toxic to cells in a number of ways. One way is the formation of reactive oxygen species (ROS), which form damaging free radicals inside the cell. The presence of too many ROS leads to inflammation and cell death. Another result of high glucose concentration inside the cell is the formation of advanced glycation end products (AGEs). AGEs can damage cells and even kill them. The result of all this damage to the endothelial cells is inflammation of the arterial lining. LESS

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