Histochemical methods were used to study the dynamics of activity of energetic metabolism enzymes (EME) in cell elements of the human coronary artery (CA) wall in comparison with biochemical values of lipid metabolism in the plasma. The development of CA atherosclerosis was shown to be determined to a large extent by reciprocal relations of antiatherogenic alpha-lipoproteins and atherogenic beta-lipoproteins in their influence on EME activity. An increased EME activity at early stages of atherogenesis (lipid plaque) is an adaptation to changed homeostasis. The lipid plaque is a turning point in the process of metabolic adaptation. Evolution of atherosclerotic changes is accompanied by disjunction and transformation of correlative connections between EME activity in CA wall cells.