How Atherosclerosis cause endothelial injury?

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Atherosclerosis is characterized by the accumulation of lipids, particularly cholesterol and cholesterol esters, within the intima of major blood vessels. According to Robbins and Cotran, this process is primarily driven by endothelial injury rather than dysfunction, which results in increased permeability, elevated expression of adhesion molecules, and altered endothelial function. The discussion raises questions about how risk factors like hyperlipidemia, hypertension, smoking, and diabetes mellitus contribute to endothelial dysfunction. While hypertension can damage the endothelium, it is suggested that this typically leads to thrombosis rather than atherosclerosis, which is more directly associated with myocardial infarction (MI). The inquiry is framed within the context of cardiovascular pathology rather than as an academic assignment.
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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.
 
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Is this a homework or coursework question?
 
This isn't any homework, I am just asking my query when going through CVS Pathology.
 

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