ELN and atherosclerosis: The causative effects of risk factors such as diabetes mellitus, hypercholesterolaemia, age, hypertension, smoking and alcohol abuse on atherosclerosis are well recognised.17 Narrowings or occlusions occur in the vasa vasorum of the atherosclerotic aorta, which result in an increase in the levels of elastase enzyme, a decrease in the levels of anti-protease enzyme and degradation of the elastin.