Cholesterol and repair processes in arteriosclerosis

The high cholesterol content of the atheroma and the correlation between elevation of the serum cholesterol and myocardial infractions gave rise to the lipid theory of arteriosclerosis, which assumes that cholesterol induces arteriosclerotic lesions and that its reduction counteracts their development. However, many facts contradict this theory. Therefore, a new hypothesis has been based on the high cholesterol content of old pathological lesions of granulomatous nature and the similarity of atheromata to granulomas. In the latter, a complicated tissue containing a high percentage of cholesterol is deposited in response to the injurious agent, which becomes walled off by this tissue. Thus, cholesterol forms part of a protective mechanism, a hypothesis compatible with the known facts about the relationship of cholesterol to arteriosclerosis.