Hyperhomocysteinemia, Hyperglycemia, Hypertension, Oxidative Stress, and Inflammation = Atherosclerosis

Given that pathological changes to the liver cause a reduction in plasma LDL and Lp(a), it doesn't necessarily follow that cholesterol is a causal factor in pathological conditions. Especially if an individual has normal cholesterol metabolism, and isn't shoveling in excessive canisters of saturated fats (paraffins/waxes) and hydrogenated oils (gasoline) into their mouths, plasma cholesterol (HDL, LDL, ILDL, VLDLDL, Lp(a) are responses to other conditions. Something that is often misunderstood is that there are many kinds of fat, only one cholesterol, free cholesterol, esterified cholesterol, and several lipoproteins that include cholesterol. Cholesterol on its own is not water soluble. Cholesterol can only travel through the blood if part of a protein or polar lipid shuttle, such as that constituted by lipoproteins. LDL then is NOT cholesterol, but ApoB protein and cholesterol which serves to shuttle cholesterol through the blood to where it is supposed to go. These proteins, ApoA, ApoB, ApoE, ApoJ, Apo(a), etc. are not just randomly secreted by the liver. They are made for a purpose under the control of a homeostat protein. Just as rusted (oxidized) or rotten food can poison someone, so can rusted or rotten lipoprotein (oxidized LDL, ox-LDL, ox-phospholipid, nitrated, glycated, chlorinated, denatured lipid/lipoprotein) poison the repair system of the artery. This poison dump causes a local immune system reaction to attempt to clear out the junk yard. Yet, each soldier (white blood cell) that comes to the site gets poisoned and dies there in the graveyard (foam cell lesion that becomes necrotic core). This graveyard then gets bigger and bigger, until it is finally the atherosclerotic lesion.

It is true that it is associated with pathological conditions, and that hereditary hypercholesterolemia and build up syndromes cause disease. It is also true that some individuals have a genetic predisposition to higher Lp(a) or LDL levels. Yet, it is also true that natural and ubiquitous hormones such as testosterone and naturally produced and occurring antioxidants such as CoQ(10) can dramatically lower this "harmful" cholesterol.

So then, without a person inhaling several burgers, a grocery bag of trans-fat fries, and an entire gallon of whole milk ice-cream a day, what is it?