Dr. Malcolm Kendrick analyzes the hypothesis that atherosclerotic plaque develops when the rate of damage to the endothelium exceeds the body’s rate of healing. This means factors that can cause plaques to develop and grow accelerate endothelial damage, create larger and more difficult-to-clear thrombi, and/or impair healing. Kendrick provides examples of these factors — examples as diverse as sickle cell disease, taking immunosuppressants, and smoking — and claims this hypothesis for the cause of cardiovascular disease links risk factors that may not seem to have anything in common.