摘要:Background Microbial fermentation significantly affects the flavor and efficacy of tea. It is generally believed that fermented tea is more effective in lowering lipids, while unfermented tea can more effectively inhibit inflammation. However, there is not sufficient evidence to support this claim. To systematically compare the hypolipidemic, anti‐inflammatory, and anti‐atherosclerotic effects of tea before and after microbial fermentation, hyperlipidemic rats and inflammatory injury cells were treated with Monascus purpureus ‐fermented pu‐erh tea water extract (MPT) and sun‐dried green tea water extract (SGT), respectively. Results MPT, with higher levels of theabrownins, flavonoids, gallic acid (GA), and lovastatin, was more effective in reducing serum triglyceride (TG), total cholesterol (TC), low‐density lipoprotein cholesterol (LDL‐C), and inflammatory cytokines (TNF‐α, IL‐1β, and IL‐6), while SGT, with higher levels of tea polyphenols, amino acids, (‐)‐epigallocatechin gallate (EGCG), and theaflavins, was more effective in increasing serum high‐density lipoprotein cholesterol (HDL‐C) in hyperlipidemic rats. The foam cells on the arterial wall of the rats in the MPT group were visibly less, and the thrombosis time was longer than that in the SGT group. Cell experiments showed that MPT was more effective in protecting endothelial cells from damage than SGT. Conclusion Surprisingly, Monascus purpureus ‐fermented pu‐erh tea not only had better hypolipidemic and anti‐atherosclerotic effects than its raw material (sun‐dried green tea), but also was superior in anti‐inflammatory effects to the latter, which was possibly attributable to the great changes in functional ingredients during microbial fermentation.