A hidden source of chronic inflammation that could be raising your risk for heart disease

When it comes to heart health, most people focus on cholesterol, blood pressure, and maybe blood sugar. But one of the most powerful and often-overlooked drivers of heart disease doesn’t start in your arteries—it starts in your gut.

More specifically, it starts with chronic inflammation, which can damage your heart and blood vessels.

Why atherosclerosis is really about inflammation

Atherosclerosis, the process behind most heart attacks and strokes, is commonly thought of as a “plaque problem.”
But the actual root cause isn’t plaque—it’s inflammation in the lining of your blood vessels.

Here’s how it works:

Your immune system responds to damage or irritation in your arteries by sending out inflammatory messengers. Over time, this leads to the buildup of fatty plaques. And when those plaques rupture, they can trigger heart attacks, strokes, or microvascular damage.

Atherosclerosis is now recognized as an inflammatory disease of the vascular system—not just a cholesterol imbalance (Libby, 2023; Ridker, 2019).

But what’s triggering all that inflammation in the first place?

In many cases, it’s your gut.

How does your gut trigger systemic, chronic, inflammation?

Your gastrointestinal tract isn’t just responsible for digestion.  It’s home to roughly 70% of your immune system. That’s because your gut lining is your body’s largest interface with the outside world—processing not just food, but also bacteria, toxins, and antigens that your immune system constantly monitors.

When the gut lining becomes compromised—a condition known as intestinal permeability or more commonly “leaky gut”—harmful substances like lipopolysaccharides (LPS), microbial fragments, and food proteins can leak into your bloodstream. This activates the immune system and triggers a chronic, low-grade inflammatory response (1), (2).

And that inflammation doesn’t stay in your gut.
It travels throughout your body—damaging tissues, driving up hs-CRP levels, and inflaming your blood vessels.(3), (4), (5), (6).

Over time, this chronic inflammatory response contributes to:

• Endothelial dysfunction (which interferes with your arteries' ability to relax and contract)
  
• Plaque formation and arterial stiffening
  
• Microvascular disease—damage to tiny blood vessels that doesn’t show up on a standard cardiac workup
  
• And ultimately, an increased risk of heart attack, stroke, and heart failure

You could be experiencing gut-driven chronic inflammation if you notice:

• Joint or muscle pain that’s unexplained
• Fatigue, brain fog, or low mood
• Skin issues like eczema or breakouts
• Bloating, irregular digestion, or food reactivity
• Lab markers of inflammation (like hs-CRP) creeping up

What You Can Do to Support Gut–Heart Health

Start with a 28 day gut reset to lower inflammation and reduce immune reactivity.  This gives your body a chance to recalibrate and provides valuable data about what may be helping—or hindering—your health.

✅ Remove inflammatory triggers—especially processed foods, sugars, and gluten*
*Gluten is difficult to fully break down and can leave behind peptides (like gliadin) that stimulate immune activity (7), (8).  Modern wheat is often sprayed with glyphosate, which may worsen gut permeability and harm the microbiome (9).
✅ Include gut-supportive foods like bone broth, fermented foods 
✅ Manage stress and sleep—two of the most under-appreciated drivers of gut inflammation
✅ Track your symptoms and labs—look for shifts in digestion, energy, joints, and inflammation markers

Final Thoughts

Atherosclerosis doesn’t begin with cholesterol.
It begins with inflammation—and the gut is often where chronic inflammation starts (10).

By the time it shows up in your arteries or your labs, your gut may have been sounding the alarm for months—or even years.

So if you’re working to reduce heart risk, mitigate chronic inflammation, or feel better in your own body… don’t overlook your gut.  It's often the most impactful place to start.

References:

1. Bischoff, S. C., et al. (2014). Intestinal permeability—a new target for disease prevention and therapy. BMC Gastroenterology, 14(1), 189.
2. David, L. A., et al. (2014). Diet rapidly and reproducibly alters the human gut microbiome. Nature, 505(7484), 559–563.
3. Tang, W. H. W., & Hazen, S. L. (2022). Gut microbiota and cardiovascular health: Current evidence and ongoing clinical studies. Nature Reviews Cardiology, 19(12), 759–772.
4. Turner, J. R. (2009). Intestinal mucosal barrier function in health and disease. Nat Rev Immunol, 9(11), 799–809.
5. Van Dyken, S. J., & Lacoste, B. (2018). The immune system and vascular inflammation in the central nervous system. Nature Reviews Immunology, 18(7), 429–445.
6. Vancamelbeke, M., & Vermeire, S. (2017). The intestinal barrier: a fundamental role in health and disease. Expert Review of Gastroenterology & Hepatology, 11(9), 821–834.
7. Fasano, A. (2011). Zonulin and its regulation of intestinal barrier function: The biological door to inflammation, autoimmunity, and cancer. Physiol Rev, 91(1), 151–175.
8. Fasano, A. (2012). Leaky gut and autoimmune diseases. Clin Rev Allergy Immunol, 42(1), 71–78.
9. Mesnage, R., et al. (2013). Ethoxylated adjuvants of glyphosate-based herbicides are active principles of human cell toxicity. Toxicology, 313(2–3), 122–128.
10. Quigley, E. M. M. (2020). Leaky gut—concept or clinical entity? Current Opinion in Gastroenterology, 36(2), 117–124.