The origins of atherosclerosis

The presence of atherosclerotic lesions in young adults suggests that early stages of atherogenesis occur during childhood. The relationship of intimal lesions in childhood to fully developed atherosclerosis is briefly discussed. Factors likely to promote lipid accumulation within the arterial wall and proliferation of connective tissue elements are reviewed with particular emphasis on endothelial cell injury and the possible consequences of this for intimal smooth muscle cell proliferation.