Atherosclerotic plaques typically begin with an injury to the arterial wall before LDL is significantly involved.

“I couldn't agree more because I think it's the injury that starts the process high blood pressure shear stress that's found in the arterial circulation are factors that are causing injury perhaps to the endothelium perhaps add points of shear stress like where the blood vessel is dividing into two branches and that is the process that starts an injury and there are repair mechanisms the body uses and just like you and I agree that LDL and the whole lipoprotein system not just the earlier but the HDL may also be a part of this repair process”