Hyperlipidaemia and atherogenesis.

Hyperlipidaemia has become generally accepted as a cause of coronary artery atherosclerosis, arterial occlusion and subsequent myocardial infarction. This may be true in a few people with lipid intolerance, but for the majority, hyperlipidaemia represents a normal physiological response to another pathological process. One such disease process involves the vessel wall, which appears to suffer injury. The cause of the injury may be associated with abnormal movement in the wall and this in turn can be provoked by stress. A hypothesis encompassing these observations is proposed. It would therefore appear that hyperlipidaemia is not a cause of arterial disease, but as part of normal homeostasis, it can be a risk indicator. It is dangerous to consider hyperlipidaemia as a cause of myocardial infarction as this leads to inappropriate treatment. The lowering of cholesterol and low density lipoproteins (LDL) by any means other than sensible dieting may be likened to attempts to lower elevated white blood cell counts in cases of bacterial pneumonia, without treating the pneumonia.