The state of the lipid transport system in patients with different variants of atherosclerosis, depending on the level of heparin in the blood has been examined. It was found that the content of heparin was lowered in all the examined, the degree of heparin drop was more pronounced in cases of atherosclerosis, enhanced by disorders of blood circulation. Disturbances of the lipid transport systems were atherogenic and manifested as an increase in the content of total cholesterol and VLDL, decrease of polyunsaturated fatty acids. We believe that the disorder of the lipid transport system is associated with the depletion of heparin synthesis which should be considered as a possible pathogenesis mechanism of atherosclerosis.