Changing picture of atherosclerosis

New view puts focus on improving artery health, not just fighting blockages.

Atherosclerosis, the accumulation of fatty gunk in the arteries, is the underlying cause of most heart attacks. It's easy to think of it as a plumbing problem caused by an overload of cholesterol. In this scenario, cholesterol-filled blockages pop up in the coronary arteries, the network of blood vessels that nourish the heart muscle. Small ones protrude into the space available for blood flow, making it difficult for the artery to deliver enough oxygen-rich blood during exercise or stress; this causes the chest pain known as angina. Large blockages close off the artery, causing a heart attack.

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