Dr. Rene Malinow of the Oregon Health Sciences Center concluded that some cases of elevated homocysteine could be the result of an inherited abnormality. This would be one explanation for premature coronary artery disease that runs in families. Mostly, however, elevated homocysteine levels can be traced to inadequate or improper nutrition. Cells lining the artery proliferate and combine with protein and lipids in a mass called an atherosclerotic plaque. Plaques are commonly the first indication of cardiovascular disease.
Plaques change with time, gathering cholesterol and fat, finally becoming atheromas.
Atheromas distort the artery wall, allowing calcification. Eventually, the inside of arteries become so rough that if you run your fingers over them, they feel like bits of broken glass. When an atheroma blocks blood to the heart, it is referred to as a heart attack. When it blocks blood to the brain, it is a stroke. If the penile artery is damaged or occluded, impotence results.