What Do Cholesterol Crystals in Arterial Walls Really Mean?

Majid Ali, M.D.

Cholesterol Is Not a Demon.

The notion that cholesterol clogs coronary arteries and causes heart attacks is a grotesque distortion of the physiology and pathology of heart disease. Heart disease is not a plumbing problem. The “cholesterol-plaque-plumbing model” of heart disease is inconsistent with all known scientific facts of the functions of oxygen, cholesterol, and endos (short for endothelial cells that make up the inner lining of the cardiovascular channels).

Two Crucial Questions

Under a microscope, how often do pathologists see cholesterol crystals inside the muscle wall beneath the lining endo cells of the arteries? And how often do they find such crystals in the outer muscle layer and the tissue surrounding that? The answer: Seldom, if ever, inside the muscle wall. I told this to two pathologist colleagues, Professors Alfred Fayemi and Judy Juco, and asked if their experience was any different. They had commonly seen cholesterol crystals in plaques outside the muscle layer but could not recall them inside that layer, close to where the blood flows in the vessels. My point: cholesterol crystals form as a consequence, not the cause, of injury to the vessel wall during plaque formation. It is not rational to address the consequences and neglect the cause.

Micro-clots and Micro-plaques in the Circulating Blood

In Integrative Cardiology (2004), the sixth volume of my The Principles and Practice of Integrative Medicine, I published a large number of microscopic photographs of micro-clots and micro-plaques in the circulating blood, which clog arteries. This is as simple to understand as clogging of kitchen plumbing when the water draining through it has too much kitchen waste. There are, however, two critical differences between arteries and kitchen plumbing: (1) the inner surface of the kitchen plumbing has no self-cleansing and healing abilities; (2) the inner endo lining of arteries, by contrast, were assigned crucial healing roles. Specifically, (a) the endo cells self-heal, repairing damage to their innards; (b) participate in the removal of micro-clot and micro-plaques from the circulating blood; and (c) facilitate healing of the connective and muscle cells in the vessel wall that they may fail to protect during acute stress. Heart attacks and strokes develop when endo cells have failed in these functions.

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