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Pathology
A 50-year-old man has a 2-year history of angina pectoris that occurs during exercise. On physical examination, his blood pressure is 135/75 mm Hg, and his heart rate is 79/min and slightly irregular. Coronary angiography shows a fixed 75% narrowing of the anterior descending branch of the left coronary artery. He has several risk factors for atherosclerosis: smoking, hypertension, and hypercholesterolemia. Which of the following is the earliest event resulting from the effects of these factors?
Alteration in vasomotor tone regulation
Conversion of smooth muscle cells to foam cells
Dysfunction from endothelial injury
Inhibition of LDL oxidation
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