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Plaque, Arteries and Disease

The biology of atherosclerosis – how plaque forms, why it’s dangerous, what imaging reveals, and the evidence that reversal is possible.

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If your body were a blockbuster movie, cholesterol would be the character everyone loves to hate. We usually hear about it as the "villain" of the story—the bad guy responsible for heart trouble and clogged pipes. But if cholesterol is so truly "bad," why is it found in every single cell of your body? Why does your body work so hard to keep it around?
Imagine a high-end sports car. It is sleek, shiny, and built to handle the toughest races. On the outside, it looks absolutely perfect. But deep inside the engine, there is a tiny fuel line that has started to rust. Normally, a "check engine" light would flash on the dashboard to warn the driver that something is wrong. However, in this car, someone has placed a thick piece of black tape over the light. The driver keeps pushing the car to its limits, feeling invincible, totally unaware that the engine is struggling. Suddenly - at 100 miles per hour - the engine stalls.
Most people think a heart attack is like a lightning strike. One minute you are fine, and the next, everything changes. But science shows that heart disease is not a sudden accident. It is more like a slow story that takes forty or fifty years to write.
Many people feel a deep fear when they hear the words "clogged arteries." We often think of our heart like the plumbing in an old house. We imagine that over time, the pipes get filled with thick gunk. In this simple view, if the pipes are clear, you are healthy. If the pipes are full of gunk, you are in big trouble. We assume that people who exercise a lot will have the cleanest pipes of all.
Most people think that "clogged arteries" are just a normal part of getting old. We treat heart disease like grey hair or wrinkles—something that eventually happens to everyone if they live long enough. But what if that is wrong?
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