A few of you asked me if I could "translate" this thread into simpler terms so that others could better understand. So here goes.
Some arteries are free of atherosclerosis, even when others - in the same person - are loaded with it. Why?
If we can understand that, we can better understand what *really causes atherosclerosis, and hence, coronary artery disease.
The arteries that don't develop atherosclerosis lack "vasa vasorum", which is a separate blood supply to arterial walls.
Yes, some arteries require their own blood supply.
ahajournals.org/doi/full/10.11…
Ischemia - tissue death due to lack of oxygen - of the vasa vasorum leads to atherosclerosis.
This seems to be linked to PVAT - perivascular adipose tissue, the fat tissue that lines arteries.
ncbi.nlm.nih.gov/pubmed/21910690
Insulin resistance can cause dysfunction in this fat, leading to inflammation.
This could explain why insulin resistance leads to atherosclerosis.
ncbi.nlm.nih.gov/pubmed/15910955
There's more, but to summarize, atherosclerosis comes from the outside in, not from the inside.
Insulin resistance, obesity, and aging all lead to inflammation of PVAT, which leads to atherosclerosis.
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