Major risk factors are high animal fat diets, hyperlipidemias, hypertension, cigarette smoking, and diabetes. Other important risk factors are obesity, male gender, family history, and physical inactivity. Adult plaques are discrete, yellow white random elevations, more prominent around ostia of large branches, abdominal aorta, and coronary, popliteal, internal carotid, and cerebral arteries. Plaques may have sclerotic firm surfaces, or ulcerate with soft exposed grumous material. Plaques may become confluent with thrombosis.
Severity increases with age, into very old age.
An intimal lesion, made up of a deposition of neutral fats, cholesterol esters, necrotic debris and foam cells, with a variable chronic fibrotic inflammatory response forming a superficial fibrous cap containing smooth muscle and foam cells and lymphocytes. Ruptured abdominal aortic aneurysm also a significant cause of death. Advanced age not an indicator of immunity to atherosclerosis. Robbins Pathologic Basis of Disease. Harrison's Principles of Internal Medicine, 13th Edition.