Sixth is the realization that it is not the ‘clogged artery’ that causes heart attacks and sudden death. Rather, it is the rupture of the arterial plaque, much as an inflamed boil may burst, that causes the sudden development of a blood clot within the coronary arteries that causes a heart attack to occur. This is at its heart an inflammatory process that is not simply due to an elevated blood cholesterol concentration. Rather, it is likely due to many factors, most of which are almost certainly due to an inflamed state within the body caused by high carbohydrate diets in those with IR.