What Causes Endothelial Dysfunction?
High blood pressure,148-153 elevated LDL,123-31 low HDL,154-156 cigarette smoking,157-163 diabetes,164-169 obesity,170-172 and lack of exercise173-175 all contribute to endothelial dysfunction and the subsequent development of atherosclerosis. Additional endothelial-damaging factors include excess glucose,99,100 insulin,176 iron,177-179 homocysteine,103-122 fibrinogen,85-93 and C-reactive protein,65-82 as well as low free testosterone (in men).94-97 Homocysteine is dangerous because it can induce initial injury to the endothelium, then facilitate the oxidation of the fat/LDL that accumulates beneath the damaged endothelium, and finally contribute to the abnormal accumulation of blood components around the atherosclerotic lesion. Fibrinogen is a clotting factor that accumulates at the site of the endothelial lesion, contributing to plaque buildup or participating in the blockage of an artery by a blood clot after an unstable atherosclerotic plaque ruptures. Glucose at even high-normal l
