End-Organ Damage Mechanisms · USMLE Step 1

Why does atherosclerotic plaque calcification contribute to further end-organ damage even without thrombosis?

  1. Calcified plaque dissolves spontaneously over time
  2. Calcification stiffens the vessel wall, raising pulse pressure
  3. Calcification strongly boosts nitric oxide production
  4. Calcification recruits only fibroblasts to the site
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Correct answer: Calcification stiffens the vessel wall, raising pulse pressure

Calcification stiffens the arterial wall, impairing elasticity and buffering capacity. This increased stiffness raises pulse pressure, damaging downstream microcirculation (e.g. kidneys, brain).

Difficulty: Medium Question 15 of 20

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