Coronary artery disease begins in most individuals as a small area of fat in the wall of the artery during the teenage years and early twenties. This process, called atherosclerosis, involves both genetic and environmental factors. The "bad cholesterol" or low density lipoprotein (LDL) is a major risk factor for the development of atherosclerosis. Recent studies indicate that the modified form of LDL, oxidized LDL, is necessary for the cholesterol to build up in the wall of the artery.
The LDL particle has a central core of cholesterol and triglycerides as well as antioxidants such as Vitamin E. The core is surrounded by polyunsaturated fat and a protein called apo B-100. When free radicals modify the LDL by a process called lipid peroxidation, toxic products are released and change the structure of the proteins so that they are recognized as foreign by white cells in the walls of the artery macrophages. These macrophages fill up with fat and accumulate in the artery wall leading to progressive encroachment into the blood stream.
A heart attack results when the cholesterol plaque ruptures, platelets stick to the surface and a clot occludes the artery. Blood carries oxygen which is the fuel for the heart and without blood flow the heart cells are unable to survive and the muscles supplied by this artery die. Thus, a heart attack or a myocardial infarction ultimately results from a cholesterol build-up in the wall of the artery.
The LDL particle has a central core of cholesterol and triglycerides as well as antioxidants such as Vitamin E. The core is surrounded by polyunsaturated fat and a protein called apo B-100. When free radicals modify the LDL by a process called lipid peroxidation, toxic products are released and change the structure of the proteins so that they are recognized as foreign by white cells in the walls of the artery macrophages. These macrophages fill up with fat and accumulate in the artery wall leading to progressive encroachment into the blood stream.
A heart attack results when the cholesterol plaque ruptures, platelets stick to the surface and a clot occludes the artery. Blood carries oxygen which is the fuel for the heart and without blood flow the heart cells are unable to survive and the muscles supplied by this artery die. Thus, a heart attack or a myocardial infarction ultimately results from a cholesterol build-up in the wall of the artery.
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