Cholesterol hypothesis of atherosclerosis

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The cholesterol hypothesis of atherosclerosis (sterol hypothesis of atherogenesis) was refined by Frantz and Moore in 1969[1]. It evolved from the postulation by Adams, Bayliss and Ibrahim in 1962 as to why cholesterol accumulated in the media of the arterial vessel wall[2] into assuming this was the underlying bad thing. They noted the anoxic environment devoid of functional enzymes that, in due course, became the oxidative hypothesis of atherosclerosis[3]. The original observation of cholesterol in atheromatous vessels is attributed to Mettenheimer in 1857 although Virchow had done some similar work by 1854. Windaus showed the substance was cholesterol in 1907, although actually most is cholesterol esters such as cholesterol oleate as demonstrated by Schonheimer. Schonheimer showed the relationship with age. With the development of statins and, much later, directed-biologics, directed-cholesterol-lowering was shown to be effective.