1. Endothelium lining the arteries is damaged
2. Increases risk of blood clotting and leads to inflammatory response, causing white blood cells to move to the site
3. Over time, white blood cells, cholesterol, calcium salts and fibres build up and harden, leading to plaque (atheroma) formation
4. Build-up of fibrous plaque leads to narrowing of the artery and restricts blood flow, increasing blood pressure which damages the endothelial lining