Majid Ali, M.D. Absence of Disease Is Not Presence of Health – Part Two What Causes Heart Attacks? Of course, plaque formation in coronary arteries! What causes plaque formation? Of course, arteriosclerosis! What causes arteriosclerosis? Of course, cholesterol deposits in the blood vessel walls! Why do cholesterol deposits form there? There are risk factors: obesity, smoking, stress, hypertension and diabetes.