High shear stress. wait wait wait, no. Low shear stress. Wait wait. Low then high shear stress. Oh, okay high shear stress too.

The problem is that you don't have high shear stress WITHOUT high tensile strain, all while disregarding oscillatory tensile strain, pulsatile acceleration between peak systole and diastole, as well as vortice formation.

In my own opinion after carefully digesting all viewpoints, it seems that tensile stress and vortice formation are the most important damaging forces upon an artery.  Shear stress is most contradictory if you disregard vortical turbulence/stagnation, and once again, tensile strain.

Shear stress is basically "drag."  Like a hand in the wind palm forward, the drag on it is higher than when the hand is held parallel to the wind, creating less drag.  How high drag is better for the artery than low drag is explained by the high drag drawing the endothelium tight, like a comb over a dogs' fur in a straight, undeviating stroke.  Low drag is supposedly bad for an artery because it doesn't pull the cells tight.  To me that doesn't make a lot of sense, but when pulsatile flow (a slight backwards flow on diastole with a majority forward flow on systole) is taken account, that makes sense.  Also, vortical formation, is important, but these things are never mentioned in one sentence, causing major confusion.  It is not that hard to understand together, it makes it more confusing and ambiguous not to talk about all these things at once.  Low shear stress + pulsatile flow caused by a local pressure differential + vortices (tornados of the blood) cause the endothelium to become dissheveled.  Like taking your hand and making random circles in your pet's fur, this will cause the once linearly oriented cells to become haphazardly arranged rather than in the direction of the laminar flow.

It is counterintuitive.  LOW SHEAR STRESS causes atherosclerosis not high shear stress.  Studies in coronary arteries show a precise opposition between high shear areas free of plaque and the low shear area laden with plaque.  The problem most have is to confuse shear stress with tensile stress (combined radial, circumferential, longitudinal).  Like the thumb and the toe, they are absolutely different things.  But more confusing, when there is a big plaque, there is high shear stress in the throat it makes with lumenal occlusion. Then, high shear stress may rip open the plaque, causing thrombosis and downstream ischemia.  All the while, tensile stress is proportional to shear stress, and higher tensile stress causes more load on the force bearing elements of the arterial ECM, which invariably only causes one thing:  wear and tear (literally).

With venous systolic pressure up to ten times lower than arterial systolic pressure, it is not difficult to understand why arteries always endure more tensile strain.  Whatever the shear stress condition, tensile strain in the artery is always higher than in a vein, partially explaining why only thrombosis is found in veins but no plaque.  It is interesting to note that a vein placed in the coronary bed for bypass does then suffer plaque stenosis when it never did before.  What is the sudden difference?  Systolic pressure and tensile strain is much higher in the arterial bed.

Yet there are instances when high shear stress contributes to arterial damage, such as a biscupid aortic valve.

You'll see above, that the high shear stress area (which is invariably a zone of high tensile strain) coincides perfectly with proximal aortic dissection, the Stanford Type A, Debakey Type II dissection, as well as a frequent site of aortic root (not sinus) plaques.

Valve-Related Hemodynamics Mediate Human Bicuspid Aortopathy

Superb Blog of Blog: "Ancient Transporters: HDL and LDL Lipoproteins Carry Precious Cargo "

This is a scientific island of common sense worth visiting.  Extremely insightful and ties together things far apart for an understanding with "range."

http://drbganimalpharm.blogspot.com/2013/03/ancient-transporters-hdl-and-ldl.html

Forced Reading Versus Searched Reading

Some people will spend hundreds of thousands of dollars on forced exposure to an idea.  You have no choice but to look at it, imprinting an idea in your mind, whether you agree to it or disagree to it.  That is one approach.  There may be some big proponents you win this way, as well as big opponents.

On the other hand, the totally free, no money involved Google Blogs only attract people who resonate with your idea.  In essence, you automatically generate 100% support bases by not spending any money, not trying (at all) to attract anyone.  Agree?  Stay.  Disagree?  Okay, you didn't lose anything so don't stick around.  Especially don't stick around and disagree.  I spent $0 on gaining a philosophical support base but that is not the correct or appropriate way to look at things.  More accurately, like minded people eventually resonate toward one another try or not to keep them away from one another.

Or you can try to force the same poles of two magnets against one another, causing only repulsion, to use a metaphor.

In a way, simply typing this forces (somebody) to read this.  I didn't spend anything other than a few minutes and a few electrons doing this.  It only takes one power broker or gatekeeper to agree with you (or disagree with you as it may be) to change the intellectual terrain on which you are received.  By voicing your thoughts (for free, not forcing people to read with hundreds of thousands of dollars), you activate this possibility.  If you don't, what can happen other than nothing changing...

In this regard, I see that there are classically trained and intelligent scientists who are separating the bogus chaff of sales pitches from the drug industry from what is real, and too bad for the drug salesmen, oftentimes the real solution is not a big money maker.  Good for you, you reader!  Congratulations on finding my shared knowledge, you will not regret it but rather free yourself from the exponential chain of bullshit that will cost you lots money, time, and pain.

If you don't agree, just go away.  It is like the Flinstonian obsolete creeky old institution The Freemasons, feebly trying to make a comeback in places like Orange County, CA believe it or not.  The Freemasons don't go out like Jehovah's Witnesses trying to recruit people let alone retain them.  Come and stay, or come and go, or don't come, or stay and go, whatever.  It is totally up to you.  I simply go to a Roman Catholic church and pay my dues in work or support, it is much easier and cheaper.  Humans think they can pay their way into some unknown or worse confuse science with religion which even a priest would advise against.  But as Einstein said, "God does not play dice with the universe."  No, it is intentional. If you are so obtuse not to see these workings, it is no use to force this understanding.  A person changes his or her own mind or heart, there is no other path in intellectual concession.  A person celebrates in "changing someone else's mind."  Ridiculous.  Nobody changes anyone's mind, they change their own.

Bathe your insides with green plant juice.

Why would you do that???

TNF-alpha shreds your arteries and causes plaque to start forming

Chlorophyll prevents TNF-a from doing its business to you.

Therefore, green plant juice may prevent atherosclerosis.

Negligence. Obfuscation. Perdition. Eloquence. = NOPE

As a wise man once said, there is no long term benefit to mediocrity.  If it brings you to a show, helps make money in the short term, but is totally mundane and forgettable, all that will happen is that you as a scientist will have wasted your time, maybe even your entire life into your 60's, chasing after chimeras.  ghosts.  illusions.  nothing.  By that age, it is way too late to "start fresh."  At best, you will be a walking irrelevent obsolescence, rotting by the day to the grave, comfortably but kindly unknown to anybody.

What is worse is when someone intentionally ignores uncomfortable or contrary evidence.  Not refutes, but ignores.  Refuses to even read and acknowledge.  Then obfuscation, which some quackademians are experts at, leaves a smoke screen so thick that some people give up trying to understand them, leaving them to go their merry but incorrect way.  Of course, if these people are wrong, fallacious, or inaccurate, it is simply a matter of time before the world makes fools of them, flying them like a flag for others to ridicule.  In this way, perdition is the fire under every good scientist's ass that should make sure they are honest.  I feel the heat everyday and this does make sure that I never even entertain the thought of "fudge factor" or some white lie.  Even the most eloquent liar eventually gets turned up as a ridiculous fraud which is why I would never attempt such a moronic thing.  Such charlatans get written up in history to be ridiculed FOREVER.

Yet others do, for short term benefits or whatever.  Not me.  N.O.P.E.  If someone tries to stuff words in my mouth, I will swiftly and sternly correct their dishonesty in a very public way.  Have a question about my work? Ask me directly, not some crazy second-hand competitor. - John C. Cha

Don't let the clowns of NOPE tell you what I think as they do not know what I think.

Do not take Vitamin D for flu prevention?!? A world gone mad and dishonest.

Epidemic influenza and vitamin D

With a clear link to Vitamin D deficiency and influenza having been established by the most credible doctors and scientists to have existed, we have the same message being thrown at us:  Get flu shots.  Just in time for "flu season" which really coincides with: temperature decrease, aridity of nasopharyngeal mucous membranes, and Vitamin D deficiency (not a weakened flu virus injection deficiency).

As in literally, weakened whole flu virus and sometimes some bonus mercury if the needles were bundled in packs rather than individually.  A lot of dummies think that the flu shot is a special medicine, antibody, or nanobot going around inside you plucking off the influenza virus.  The flu vaccine IS the flu virus.  As these rigorous and conventionally trained doctors and scientists documented, Vitamin D deficiency caused this flu virus jab to spring into action and cause flu symptoms.  The symptoms were minimal to none with lots of Vitamin D.

Yet, because Big Pharma thinks we are morons and only potential consumers, they will try to persuade us to part with our money in any way imaginable.  At the top of these industries, literally the only thing that matters is money.  Murder is just fine if it means preserving a financial domain.  It is not a second thought.  If that is okay, then the other things seem like saintly occupations by comparison.  What what it be to them to lie to you about efficacy, side effects, or reason of being (money)?  As all (ethical) global intelligence agencies do, they follow the money to end at the real source of crime.

Cholesterol does not cause atherosclerosis. Oxidized cholesterol byproducts do.

Here are a few things to keep in mind:  1) Cholesterol is not soluble in water or blood.  A derivative of cholesterol that is soluble in blood or water is not cholesterol.  2) The only way cholesterol is moved around either in the blood or as an adduct is by the action of adding a hydrophilic protein or converting free cholesterol enzymatically to a soluble form.  3) The only way cholesterol gets to an artery wall is through a lipoprotein or the soluble form made first by a cell's action upon ingested cholesterol.  4) It has already been proven that native LDL is harmless to endothelial layers even in very high concentrations of the particle and that the oxLDL particle is the one that causes havoc to the endothelial layer.

That being said, even in the most severely diseased coronary artery disease (CAD) patient with acute coronary syndrome (ACS) presenting as angina, respiratory problems, and/or MI, the level of oxLDL is 4-5mg/dL maximally.  Normally, they are half this value to none.  This value of 4-5 doesn't occur until after the coronary artery disease, so how could it be that oxLDL caused the CAD?  Temporally, and logically, oxLDL could not have caused CAD if it was absent beforehand.

There is no question that toxic adducts of cholesterol DO cause arteriosclerosis and the consequence is atherosclerosis.  Is it an inevitable event that cholesterol becomes 25-hydroxycholesterol and cholestane-3beta, 5alpha, 6beta-triol, the culprits of endothelial aggravation?  No.

It is not cholesterol, it is OXIDATION that causes these culprit oxidized cholesterol molecules to arise and cause harm.  By having administered pure non-oxidized cholesterol to the artery cells with no harm, scientists made sure of the fact as early as 1976.  Extending the first post, here are younger studies confirming the first.

Effect of auto-oxidation products from cholesterol on aortic smooth muscle cells: an in vitro study.

Cytotoxicity of oxidation derivatives of cholesterol on cultured aortic smooth muscle cells and their effect on cholesterol biosynthesis.

Ironically, the hydroxycholesterol and other oxygen adducts shut off cellular cholesterol synthesis, making the matter worse as your cells, especially the fastest dividing ones, make it for a mission critical reason.  As the repeat, "Purified cholesterol showed no cytotoxic effect and minimal inhibition of cholesterol biosynthesis"

Inhibitory effect of cholesterol oxides on low density lipoprotein receptor gene expression.

Again, after two decades, the groups repeat that ". Pure cholesterol showed only minimal inhibition."

The question of importance is how much of the toxic oxygenated cholesterol is there in food?  Who would know for something boiling around in hot oil and open air for weeks?  My guess is a significant amount of cholesterol has turned to ox-cholesterol and probably stuff like that should be avoided.  Minimally cooked foods, or fresh foods would have a minimum of this toxic cholesterol derivative.  So indeed, the way meat is cooked may be a significant way to introduce these cholesterol-oxygen problem compounds in the blood, and these are indeed soluble.
 
However, like most everything, there is a reason for this artery aggravating 25-hydroxycholesterol (immune response against viruses) to exist:

Armand-Frappier Outstanding Student Award--The emerging role of 25-hydroxycholesterol in innate immunity.

25-Hydroxycholesterols in innate and adaptive immunity.

There is an enzyme that responds to interferon by hydroxylating cholesterol.  25HC is antiviral.

Given that your blood levels of ApoB bound cholesterol are from your liver and not from a vat of oil boiling around for weeks, it would not cause any arterial injury.  This is dependent on antioxidant functions preventing oxidation.  These are enzymatic, such as PON and glutathione, and enteral/parenteral such as Vitamin C, E, and A.