Atherosclerosis is the underlying cause of coronary artery disease. This results from the build up of fatty deposits inside the arterial wall over many years. Endothelial inflammation and injury, as well as the plaque buildup with lipids, macrophages, foam cells and collagen play an important part of this process.

Atherosclerotic plaque buildup leads to the narrowing of coronary arteries, reducing coronary blood flow. The blockage of coronary arteries starves heart muscle of blood (and oxygen).

Atherosclerosis occurs in the arteries throughout the body. When atherosclerosis occurs in the head and neck arteries, it can cause stroke. When it occurs in the renal arteries, it may cause kidney failure. When it occurs in the legs, it causes peripheral vascular disease.