Cholesterol buildup in your arteries may trigger inflammation. Inflammation can affect how you break down lipids like cholesterol. This link can cause both factors to increase your risk of heart disease.

If you live with high cholesterol levels, you’re not alone. Experts estimate that about 2 in 5 adults in the United States have elevated total blood cholesterol.

Cholesterol is a fatty substance your body makes. We all need some cholesterol. Our body uses cholesterol to repair cells, produce hormones, and create vitamin D.

But too much cholesterol can cause problems. It can start to build up as plaque on the walls of your arteries, narrowing them and making it harder for blood to flow through. This increases your risk of a heart attack or stroke.

Inflammation is your body’s response to what it perceives as harmful. Inflammation can also change the health of your arteries and make cholesterol more likely to cause problems.

Some research suggests that inflammation contributes to heart disease more than cholesterol. Keep reading to learn more about this link.

Cholesterol affects inflammation in a few ways.

Cholesterol exists in all your body’s cells. When cholesterol levels are high, more cholesterol enters your cells.

Research from 2015 has linked this influx of cholesterol with an increase in inflammatory proteins released by your immune system.

A buildup of plaque in your arteries can also trigger an inflammatory response in the body. This response causes more damage and contributes to heart disease.

Inflammation in your body can cause several changes in your cholesterol levels.

Research has linked inflammation to lower HDL (“good”) cholesterol levels. HDL cholesterol helps protect your heart by reducing cholesterol buildup in the blood. Low HDL is a risk factor for heart disease as cholesterol is more likely to cause plaque deposits.

Inflammation also creates denser LDL “bad” cholesterol molecules, which turn into plaque deposits more easily.

Inflammation raises another type of fat found in the blood called triglycerides. High triglyceride levels are another risk factor for heart disease.

Traditionally, we have focused on lowering cholesterol as a primary way to reduce heart disease risk. Finding ways to reduce inflammation might be even more important.

Autoimmune diseases and high cholesterol

Autoimmune diseases are a group of conditions that result from an abnormal immune response. In autoimmune diseases, the inflammatory response doesn’t turn off and starts to cause damage.

Inflammation from autoimmune diseases like lupus can be systemic. That means it can affect many body systems, including your metabolism and circulation (heart and blood vessels). These factors can cause plaque to build up more easily on artery walls.

This can contribute to an increased risk of heart disease in people with autoimmune diseases.

Research from 2019 also links low HDL levels to a higher risk of developing autoimmune diseases.

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Experts most often recommend the Mediterranean diet for people with or at risk of heart disease. This diet includes a variety of food sources of antioxidants, healthy fats, and fiber, which may help reduce inflammation in the body. It may also help lower LDL levels.

A Mediterranean diet includes:

  • a variety of fruits and vegetables
  • beans and lentils
  • whole grains
  • healthy fats from olive oil, avocado, fish, nuts, and seeds
  • moderate amounts of poultry, eggs, and dairy products

Medications can also be an important part of preventing or managing heart disease. This is especially true if you have a personal or family history of high cholesterol or heart disease.

Managing or preventing heart disease also involves managing other risk factors for heart disease. Steps to take include:

Is cholesterol part of the inflammatory response?

Cholesterol is not directly involved in the inflammatory response. Although the immune system sends out various inflammatory proteins, it doesn’t make cholesterol. Your liver makes cholesterol.

Still, higher cholesterol levels can increase inflammation by triggering an immune response.

Can high cholesterol cause joint pain and inflammation?

It seems like high cholesterol and joint pain wouldn’t be connected, but there may be a link. Joint pain is often due to inflammation, which has links to high cholesterol.

A 2021 study explored knee pain and high cholesterol in older adults with osteoarthritis. Researchers found that those with high cholesterol had more knee pain.

Keep in mind that this doesn’t mean cholesterol causes joint pain — just that there may be a link.

Can high cholesterol cause swelling?

High cholesterol doesn’t directly cause swelling. As part of an inflammatory immune response, your body sends extra blood and fluids to an affected area. The extra fluid gathers in the body’s tissues, resulting in swelling.

High cholesterol can contribute to other conditions, like blood clots, which can cause swelling.

Inflammation and cholesterol are both risk factors for heart disease. Several studies suggest that inflammation could be the main driver of heart disease.

High cholesterol may lead to fatty deposits in the arteries called plaque. This is more likely to happen when there is inflammation in the arteries.

Managing and preventing heart disease isn’t just about managing your cholesterol levels. It includes managing other risk factors, including inflammation.