ET-1 contributes to the vascular dysfunction associated with cardiovascular disease, particularly atherosclerosis and hypertension. Chronic inflammation contributes to an increased risk of hypertension, atherosclerosis and diabetes. Carotid stenosis may occur in patients with atherosclerosis. Indians are at particularly high risk for atherosclerosis and coronary artery disease. People with obesity are at increased risk of atherosclerosis of the coronary arteries. The cause of death was occlusive coronary atherosclerosis. It is associated with an increased risk of stroke, myocardial infarction, atherosclerosis and hypertension. Elevated LDL levels are associated with diabetes, hypertension, hypertriglyceridemia, and atherosclerosis. Smoking also increases the chance of heart disease, stroke, atherosclerosis, and peripheral vascular disease. Explanations include microvascular dysfunction or epicardial atherosclerosis. The obstruction being bypassed is typically due to arteriosclerosis, atherosclerosis, or both. New studies associate loud "snoring" with the development of carotid artery atherosclerosis. These include aortic aneurysms, dissections, direct trauma to the aorta, surgeries, and atherosclerosis. Macrophages are the predominant cells involved in creating the progressive plaque lesions of atherosclerosis. Chronic carbon monoxide exposure might increase the risk of developing atherosclerosis.