The Importance of Oxidized LDL Cholesterol

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Having high LDL cholesterol levels can place you at risk for developing cardiovascular disease. Guidelines recommend that your LDL levels should be below 100 mg/dL. However, not only does having high LDL cholesterol levels place you at risk for heart disease, the type of LDL particles circulating in your blood can also make a difference. LDL particles can range between large and buoyant to small.

Smaller LDL particles are more likely to become oxidized, making them more detrimental to your cardiovascular health. Oxidized LDL can produce inflammation in arteries that supply blood to your organs and other tissues, thus promoting atherosclerosis and increasing your risk of having a heart attack or stroke.

How Does Oxidized LDL Form?

The oxidation of LDL is thought to occur when the LDL cholesterol particles in your body react with free radicals. The oxidized LDL itself then becomes more reactive with the surrounding tissues, which can produce tissue damage. Some of the things that appear to increase levels of oxidized LDL include:

  • Consuming a diet that is high in trans fats
  • Smoking
  • Having poorly controlled diabetes
  • Being diagnosed with metabolic syndrome

Once LDL becomes oxidized, it goes directly within the inner lining (endothelium) of any artery in the body, including the carotid artery, coronary artery or the arteries that supply your legs and arms with blood.

Once there, it encourages the accumulation of inflammatory cells, such as macrophages, and platelets at the site of the vessel and promotes their adhesion to the damaged area. More macrophages, cholesterol and other lipids begin to accumulate at the site, forming a plaque that begins to grow thicker.

Over time, this can slow — or completely restrict — the amount of blood flow that travels to one or more areas of the body. This can result in a variety of health conditions, including coronary heart disease, peripheral vascular disease, or dementia.

What Can You Do to Prevent the Formation of Oxidized LDL?

There are many things you can do to prevent the formation of oxidized LDL, and many of them involve making a few changes to your everyday habits to lower your LDL cholesterol, such as:

  • Stop smoking.
  • Exclude trans fats from your diet. Food that may contain trans fats include pastries, deep fried foods, potato chips and other foods cooked with lard.
  • Add fruits and vegetables to your diet. Not only do they contain plenty of nutrients and are low in fat, they also possess antioxidants with anti-inflammatory properties that may help to reduce the oxidation of LDL.
  • If you have been diagnosed with diabetes or metabolic syndrome, get these conditions under control. This would include losing weight, eating healthy and exercising. If lifestyle changes are not helping you to control your blood sugar levels and weight, your healthcare provider may talk to you about taking medication to control these conditions.

    In some cases, you may need medication to help lower your cholesterol. Some of these cholesterol-lowering medications, such as statins, also possess anti-inflammatory properties that can lower your cholesterol and prevent the inflammation that helps to establish the formation of atherosclerosis.


    Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (PDF), July 2004, The National Institutes of Health: The National Heart, Lung, and Blood Institute.

    Dipiro JT, Pharmacotherapy: A Pathophysiological Approach., 9th edition. McGraw-Hill Education 2014.

    Trpkovic A, Resanovic, Stanimirovic J et al. Oxidized Low-Density Lipoprotein as a Biomarker of Cardiovascular Disease. Crit Rev Clin Lab Sci 2015; 52: 70-85