How can cholesterol deposits contribute to atherosclerosis?

Atherosclerosis is a condition characterized by the accumulation of fatty substances, primarily cholesterol, within the inner walls of arteries. This process typically begins when the inner lining of a blood vessel, the endothelium, sustains injury due to factors such as high blood pressure or elevated levels of cholesterol and triglycerides.123

Once the endothelium is damaged, cholesterol-rich lipoproteins and other cellular debris accumulate at the site. Immune cells called macrophages attempt to remove these lipids but become overwhelmed, transforming into "foam cells" that eventually die and contribute to the growing mass. Over time, this mixture of fat, cells, and connective tissue forms a fatty plaque known as an atheroma.32

As these plaques enlarge, they narrow the arterial lumen, restricting blood flow and reducing oxygen delivery to vital organs. Furthermore, these plaques can become calcified or rupture, potentially triggering the formation of blood clots that may lead to life-threatening events such as heart attacks or strokes.31