Infective endocarditis is most often caused by

Hypertension, or high blood pressure, is a major risk factor for the development of left ventricular hypertrophy (LVH), which is characterized by thickening of the myocardium (heart muscle). LVH occurs in response to increased afterload (the resistance the heart has to pump against), which is a common feature of hypertension.

Angiotensin II, a hormone that is activated in response to hypertension, is a major mediator of LVH in this setting. Angiotensin II causes vasoconstriction (narrowing of blood vessels) and promotes the retention of salt and water, which increases blood volume and pressure. Additionally, angiotensin II stimulates the proliferation of cardiac myocytes (heart muscle cells) and the synthesis of extracellular matrix proteins, leading to hypertrophy and fibrosis of the myocardium.

Other factors that may contribute to LVH in hypertension include increased sympathetic nervous system activity, oxidative stress, and inflammation. However, angiotensin II is considered a key mediator of this process, and drugs that block the renin-angiotensin-aldosterone system (RAAS), such as angiotensinconverting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), are often used to treat hypertension and reduce the risk of LVH and other cardiovascular complications.

Atherosclerosis is a disease in which fatty deposits (plaques) build up in the walls of arteries, leading to narrowing and reduced blood flow. Elevated levels of certain lipids, including low density lipoprotein (LDL) cholesterol and triglycerides, are well-established risk factors for the development of atherosclerosis.

In contrast, high density lipoprotein (HDL) cholesterol has been shown to have a protective effect against atherosclerosis. HDL is often referred to as "good cholesterol" because it helps to transport excess cholesterol from peripheral tissues (including the walls of arteries) back to the liver for processing and excretion. HDL also has anti-inflammatory and antioxidant properties that may help to reduce the risk of atherosclerosis.

In general, higher levels of HDL cholesterol are associated with a lower risk of cardiovascular disease and atherosclerosis. However, the protective effect of HDL may vary depending on other factors such as smoking, obesity, and diabetes. It is important to maintain a healthy balance of lipids in the bloodstream, including a high level of HDL and low levels of LDL and triglycerides, in order to reduce the risk of atherosclerosis and other cardiovascular diseases.