Atherosclerosis causes accumulation of lipids (cholesterol, cholesterol esters) within the intima of major vessels."Robbins and Cotran, 8 edi." says it is due to endothelial injury rather endothelial dysfunction,which leads to increased permeability, inc. expression of adhesion molecules, altered endothelial function. but how these risk factors (hyperlipidemia, hypertension, smoking, diabetes mellitus) causes endothelial dysfunction ? Although Hypertension can damage endothelium, but it must manifest as a case of thrombosis rather than atherosclerosis, leading to MI.