Atherosclerosis is caused by arterial inflammation and lipid accumulation rather than cholesterol alone
Contemporary cardiovascular research confirms that atherosclerosis is driven by an interplay of arterial inflammation and lipid accumulation rather than cholesterol levels alone.
Multiple peer-reviewed studies establish that atherosclerosis is a complex disease driven by both lipid deposition (such as LDL and remnants) and chronic vascular inflammation. The retrieved papers consistently emphasize that inflammation and immune responses work hand in hand with lipid imbalances to form and progress atherosclerotic plaques, supporting the claim.
Khojasteh Malekmohammad, E. Bezsonov, M. Rafieian-kopaei. Role of Lipid Accumulation and Inflammation in Atherosclerosis: Focus on Molecular and Cellular Mechanisms. 2021. https://doi.org/10.3389/fcvm.2021.707529
Highlights that atherosclerosis is a chronic lipid-driven and maladaptive inflammatory disease where lipid homeostasis and inflammatory pathways interact closely.
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Sophia Strukel, Betelhem Teshome, Vikrant Rai. The Multifaceted Role of Platelets in Atherosclerosis and Ischemic Disease: Pathogenesis, Inflammation, and Therapeutic Opportunities. 2025. https://doi.org/10.3390/life15111656
Notes that chronic inflammation, lipid accumulation, and endothelial dysfunction play critical roles in the pathophysiology of atherosclerosis.
Feng Lyu, W. Long, Limin Ma. Atherosclerosis-induced arterial erectile dysfunction: pathogenesis, diagnosis, and therapeutic strategies. 2025. https://doi.org/10.21037/tau-2025-241
Confirms that atherosclerosis is characterized by arterial wall inflammation, lipid accumulation, and endothelial damage.
Qianqian Zheng, Liang Duan, Yunwei Lou, Tianzhu Chao, Guo Guo, Liaoxun Lu, Hongxia Zhang, Yucong Zhao, Yinming Liang, Hui Wang. Slfn4 deficiency improves MAPK-mediated inflammation, oxidative stress, apoptosis and abates atherosclerosis progression in apolipoprotein E-deficient mice.. 2021. https://doi.org/10.1016/j.atherosclerosis.2021.10.010
Demonstrates that modulating vascular inflammation alongside lipid accumulation abates atherosclerosis progression.
Evgeny E Bezsonov, N. Chernyi, Mane Saruhanyan, Dariia Shimchenko, N. Bondar, Darina Gavrilova, Mirza S. Baig, A. Malogolovkin. Gene Therapy Approaches for Atherosclerosis Focusing on Targeting Lipid Metabolism and Inflammation. 2025. https://doi.org/10.3390/ijms26146950
Emphasizes that both lipid accumulation and local inflammation are key components driving the induction and progression of atherosclerosis.
Nan S, Peng C, Meng X, Jia J, Zhao F, Cui Y. Targeting lipophagy in atherosclerosis: Molecular mechanisms, pathogenesis and therapeutic interventions (Review).. 2026. https://doi.org/10.3892/mmr.2026.13918
States that the imbalance between cholesterol influx and efflux, coupled with persistent inflammation, drives plaque formation.
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