Beware of the Combination of Hyperlipidemia and Inflammation

Combining these two conditions might create a pivotal risk factor for cardiovascular disorders, but they are manageable.

Like sugar, fats also create a paradoxical situation for the body. Too much or too little lipids (dyslipidemia) can be problematic for the homeostasis, function, and performance of the body.

In this post, I focus on hyperlipidemia which refers to excessive fat molecules in the bloodstream caused by multiple factors. If untreated, hyperlipidemia can lead to severe health issues.

I also touch on chronic inflammation, as when combined with hyperlipidemia, the risk factors for cardiovascular diseases skyrocket. Therefore hyperlipidemia and inflammation play a pivotal role.

I structured the article under three headings. First, I provide an overview of hyperlipidemia and inflammation. Then I discuss their combined effects as paramount risk factors for cardiovascular diseases and other metabolic disorders, creating a catch-22 situation.

The combination is a catch-22 situation as they create each other in intricate ways yet to be understood by scientists and clinicians, and they soar the risks of heart attacks and strokes.

Therefore, patients with both conditions face a dilemma caught in unfavorable outcomes. So metaphorically, marrying these two conditions must be prevented diligently, systematically, and proactively with lifestyle choices and professional support.

Part 1 — What is hyperlipidemia, why does it matter, and how to optimize it?

Summary of Major Lipids

Any abnormality of lipids in the body is called dyslipidemia. However, I only cover hyperlipidemia which is an excess amount of lipids.

First, Let me introduce three major lipids (cholesterol, triglycerides, and phospholipids) with distinct structures and functions in the body. I documented them in previous articles but will briefly describe them here for new readers.

Cholesterol and phospholipids are essential for cell membranes and the synthesis of hormones. Triglycerides are a primary form of stored energy.

Cholesterol is a sterol lipid in cell membranes. It is essential for synthesizing hormones like vitamin D and sex hormones. Lipoproteins (LDL and HDL) transport it in the bloodstream.

Triglycerides swim in the bloodstream and are stored in adipose tissue. They are used as fuel when energy is needed. Triglycerides comprise three fatty acids and a glycerol molecule. Lipoproteins like VLDL (very low-density lipoprotein) transport them in the bloodstream.

Phospholipids exist in cell membranes and have a similar structure to triglycerides, with a glycerol backbone and fatty acid tails, but they also contain a phosphate group and a polar head group. HDL and ATP-binding cassette transport phospholipids.

An Overview of Hyperlipidemia

Hyperlipidemia is characterized by abnormally high levels of lipids in the blood. The above-mentioned lipids: cholesterol, triglyceride, and phospholipids, affect them.

The most common type of lipid elevated in hyperlipidemia is LDL cholesterol. Cholesterol is important for various bodily functions, but too much of it with other factors might lead to cardiovascular diseases.

The National Library of Medicine published a helpful book chapter in 2022 authored by Marcus Hill and Bruno Bordoni. I summarize the key points, and you might read the details for free at this link.

Scientists classify hyperlipidemia under two major categories:

1 — Hypercholesterolemia (elevated cholesterol levels)

2 — Hypertriglyceridemia (elevated triglycerides levels)

These names are self-explanatory from causal aspects. Different factors can trigger these conditions, leading to different health consequences.

Hyperlipidemia is categorized as primary (familial) and secondary (acquired). Primary hyperlipidemia is associated with genetic disorders. Secondary hyperlipidemia originates from lifestyle factors, medications, hypothyroidism, and uncontrolled diabetes.

From a diet perspective, excessive trans fats and saturated fats might cause it. The evidence is still inconclusive. However, indirectly excessive sugar turning into visceral fat is a major cause.

For example, in this video, medical doctor Kevin Berry asserts that healthy fats do not cause an elevation of triglycerides. They are mainly caused by eating high amounts of refined carbs.

Another medical doctor clarifies the cholesterol paradox in a YouTube video titled “Cholesterol is NOT the cause of heart disease. I’ll prove it,” cholesterol is not the primary cause of heart disease.

From dietary and lifestyle perspectives, the key risk factors of hyperlipidemia are obesity, a sedentary lifestyle, smoking, and unmanaged stress. A combination of them causes other conditions, like inflammation which I cover in the next section.

When levels of LDL cholesterol and triglycerides are persistently high, they can build up in the arteries and form plaques called atherosclerosis.

This paper informs, “Dietary phospholipids have been demonstrated to decrease the serum total cholesterol and low-density lipoprotein cholesterol levels and change total/HDL in humans.”

Plaques in endothelial cells that line blood vessels can narrow the arteries. Then ruptured plaques can cause blood clots to form, blocking blood flow and leading to cardiovascular diseases like coronary artery disease, heart attacks, and strokes.

I documented ten steps to improve the health of the endothelial cells, lowering the risks of cardiovascular disorders. Endothelial cells regulate blood flow, prevent clotting, maintain vessel integrity, form new vessels, balance fluids, and modulate immune responses.

Treatments (lifestyle changes, medication, and surgery) are available to manage hyperlipidemia. If left untreated, hyperlipidemia can increase the risk of developing heart disease, stroke, and other health problems.

The key point is preventing the formation of atherosclerosis. Managing risk factors of hyperlipidemia to atherosclerotic cardiovascular disease is referred to as “primary prevention” in the literature.

Part 2 — What is inflammation, why does it matter, and how to optimize it?

The body induces inflammation to rescue damaged tissues by recruiting plasma proteins and leukocytes to the affected areas. As a result, the affected tissues create an adaptive response.

Like stress, inflammation is paradoxical because a timely and adequate amount is crucial for survival. More importantly, the body cannot heal injuries without inflammation.

However, the body sees it as toxic in large amounts and for extended times. Thus, chronic inflammation causes complications that destroy the body’s homeostasis in the long run.

National Health Institute (NIH) reported the causes of chronic inflammation under six categories. I summarize them to understand the reasons for the body gets inflamed chronically.

“1 — Failure to eliminate the agent causing an acute inflammation.

2 — Exposure to a low level of irritant or foreign material that the body cannot eliminate with enzymatic breakdown or phagocytosis.

3 — An autoimmune disorder in which the immune system recognizes the normal component of the body as a foreign antigen, attacking healthy tissues.

4 — A defect in the cells responsible for mediating inflammation leading to persistent or recurrent inflammation.

5 — Recurrent episodes of acute inflammation.

6 — Inflammatory and biochemical inducers causing oxidative stress and mitochondrial dysfunction like increased production of free radical molecules, advanced glycation products, uric acid crystals, oxidized lipoproteins, and homocysteine.”

According to NIH, major risk factors are associated with chronic inflammation. They are age, obesity, diet, stress, sleep disorders, smoking, and low sex hormones.

Except for age, all risk factors can be addressed via healthy lifestyle habits and support from qualified healthcare professionals.

Inflammatory responses triggered by high levels of lipids can lead to the activation of immune cells. They can contribute to the formation of plaques on the walls of arteries.

Chronic inflammation can damage the walls of blood vessels, adding more lipids and forming plaques. Besides, inflammation can affect the production and metabolism of lipids, leading to higher levels of circulating lipids.

The accumulation of lipids in the walls of arteries can cause oxidative stress. It can also contribute to inflammation creating a catch-22 situation.

More specifically, reactive oxygen species can react with lipids in the arteries' walls, forming oxidized lipids, which can trigger an inflammatory response.

Hyperlipidemia can induce endoplasmic reticulum stress, a type of cellular stress that occurs when misfolded or unfolded proteins accumulate.

An excessive amount of oxidative stress and inflammation might promote the growth of plagues in arteries. Besides, inflammation can loosen plaque in the arteries and trigger blood clots, as documented in this source.

From endothelial cells and atherosclerosis perspectives, patients might have a heart attack when a blood clot blocks an artery to the heart. However, if the blood clot clogs an artery to the brain, they have a stroke.

The critical point to lower chronic inflammation is to reduce inflammatory causes and increase anti-inflammatory mechanisms. Our healthy lifestyle approaches can contribute to this two-pronged approach.

Healthy lifestyle habits can contribute to decreasing chronic inflammation. The key points: controlling blood sugar, making the body more insulin sensitive, reducing visceral fat, regular exercise, customized nutrition, cutting inflammatory food, and getting enough restorative sleep.

Despite healthy habits, some people might need anti-inflammatory medication or treatment. Thus getting inflammation markers checked, diagnosed timely, and obtaining a corrective plan is essential.

Part 3 — The Combined Effects of Hyperlipidemia and Chronic Inflammation

When hyperlipidemia and inflammation occur together, it can increase the risk of developing atherosclerosis. This process is complex and involves several steps.

Older scientists used to focus on cholesterol for plague formation. But the new generation of scientists focuses on inflammation, considering the cholesterol paradox, seeing it as the firefighter stuck in an incident.

Elevated levels of lipids might cause damage to the walls of the blood vessels. This damage can trigger an inflammatory response. Inflammation releases chemicals and immune cells to repair the damaged tissue.

If inflammation becomes chronic, it can contribute to the development of atherosclerosis. It can cause immune cells to accumulate in the arterial wall and form fatty spots, eventually forming plaques.

Over time, these plaques can grow in size and narrow the artery, reducing blood flow to the heart or brain. A plaque rupture can cause a blood clot, blocking blood flow and leading to a heart attack or stroke.

The critical point is that the combination of hyperlipidemia and inflammation can contribute to the development and progression of atherosclerosis, increasing the risk of heart disease and stroke.

Furthermore, the combination of hyperlipidemia and inflammation can lead to metabolic syndrome, nonalcoholic fatty liver disease, insulin resistance, pancreatitis, hypertension, and type 2 diabetes, increasing the risks of cardiovascular diseases.

Therefore, managing hyperlipidemia and inflammation is essential to reduce the risk of developing these conditions.

Literature also indicates that a combination of hyperlipidemia and inflammation might increase the risk of developing neurodegenerative disorders like Alzheimer’s. I will cover them in another article.

Summary and Conclusions

Cardiovascular diseases are the leading cause of death globally. A combination of hyperlipidemia and inflammation increases the risks substantially.

Therefore they must be managed proactively, diligently, and systematically with support from qualified healthcare professionals. We must take personal responsibility and get timely professional support.

This paper informs that “statins are the mainstay treatment for hyperlipidemia. However, the limitations of statins include treatment resistance, intolerance due to adverse events, and a lack of adherence which contribute to poor outcomes.

As such, many patients require adjunct therapies to properly control hyperlipidemia, including niacin, bile acid sequestrants, fibric acids, and ezetimibe. Guidelines for the management of patients with hyperlipidemia vary in their recommendations.”

Statin medications work by blocking the HMG-CoA reductase enzyme responsible for producing cholesterol in the liver. By inhibiting this enzyme, statins reduce the amount of cholesterol produced by the liver, reducing the amount of LDL and possibly increasing HDL.

Statin medications having different active ingredients are sold under brand names such as Lipitor, Crestor, Zocor, Lescol, Livalo, and Pravachol. There might be different names in different countries.

Hyperlipidemia and chronic inflammation are major risk factors for the development of cardiovascular disease and other metabolic disorders. However, the body needs fats and inflammation in small amounts.

Takeaways

Here are some practical tips for managing hyperlipidemia and inflammation and lowering the risks of cardiovascular disorders.

1 — Fix your diet by getting adequate calories and nutrients from whole foods. Customizing your diet for your needs is the best option.

2 — Move the body regularly, and manage your weight.

3 — Get nightly restorative sleep, take breaks, rest, recover, have fun, manage your stress, and improve your social connections.

4 — Quit smoking and avoid other toxins, drugs, and excessive alcohol.

5 — Regularly get your lipids and inflammation markers checked. If abnormalities exist, ask your family physician for referrals to relevant specialists timely.

6 — Follow the guidelines specialists provide and take your medications for both conditions until they ask you to stop.

7 — Learn symptoms of cardiovascular diseases from your family physician and if you experience sever ones immediately call an ambulance for an emergency department as an early medical intervation can save your life.

We cannot do much about aging and genetics, but we can improve our cardiovascular health with healthy lifestyle choices and timely professional support.

Understanding mechanisms, impacts, implications, and viable solutions for managing hyperlipidemia and inflammation can help us take control of our health and reduce our risk of developing these common disorders.

I wrote about cardiovascular diseases, particularly heart disease, and strokes. These stories have practical tips, including valuable molecules like nitric oxide, nutrients like citrulline malate and COQ10, and improving endothelial cells, in addition to the points mentioned in this story.

Thank you for reading my perspectives. I wish you a healthy and happy life.

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