How Does High Cholesterol Lead to Cardiovascular Disease?

by Lisa Nelson, RD, LN Health Professional

I was recently asked the following question. If you are faced with heart disease or concerns about high cholesterol I thought you may also enjoy knowing the answer, which I've included below.

How does high cholesterol lead to cardiovascular disease?

Let me see if I can explain and keep the process easy to understand

First the endothelium (thin inner lining of your blood vessels) becomes damaged and inflamed. This damage can be caused by a variety of factors, such as high blood pressure, high stress level, poor diet, toxic chemicals and metals, tobacco smoke, etc.

The inflamed endothelium becomes susceptible to circulating fatty particles, such as cholesterol, and attracts them. The cholesterol particles work their way into the endothelial lining. These deposits of cholesterol can then be damaged by free radicals to form oxidized LDL cholesterol. There is an important point here the needs to be emphasized. The LDL cholesterol circulating in your blood stream is not harmful to your cardiovascular health until the LDL cholesterol becomes oxidized. The immune system responds to the inflamed site by secreting a substance to make the endothelium sticky. The process leads to the formation of macrophages whose goal is to "seek and destroy" foreign objects. The macrophages attempt to engulf and remove the oxidized LDL; however, the oxidized LDL is toxic to macrophages. This causes the macrophages to be immobilized and unable to return to the blood stream.

The process continues to draw white cells to the area where they too are immobilized by oxidized LDL leading to the formation of a "fatty streak" on the artery wall. A number of steps now take place involving C-reactive protein, fibrinogen, white blood cells, elastin, and collagen that eventually form a tough, fibrous cap over the fatty steak. Under the fibrous cap, dead cells accumulate, decay, and produce pus. You now have the development of a dangerous plaque within your artery walls. Plaque can continue to grow and instigate the development of additional plaque within the arteries. This all leads to the narrowing of your blood vessels (atherosclerosis), reduced blood flow, heart attacks, etc.

FYI - Cholesterol does not necessarily need to be elevated for the above steps to take place.
Knowing your LDL and HDL particle size gives you a better overview of your heart health than typical cholesterol levels. Particle size can be determined with lab work, such as a Lipoprotein Particle Profile.

Be sure to sign-up for the free e-course How to Lower Cholesterol in 8 Simple Steps.

Lisa Nelson, RD, LN
Meet Our Writer
Lisa Nelson, RD, LN

Lisa Nelson RD, a registered dietitian since 1999, provides step-by-step guidance to lower cholesterol and lower blood pressure, so you can live life and enjoy your family for years to come. Lisa's passion for health comes from her own family history of heart disease, so she doesn't dispense trendy treatments; Lisa practices what she teaches in her own daily life. Because her own health is the foundation of her expertise, you can trust that Lisa will make it truly possible for you to see dramatic changes in your health, without unrealistic fads or impossibly difficult techniques.