What Happens to Your Blood Pressure When You Have High Cholesterol

High cholesterol can raise blood pressure because it contributes to plaque build-up in your arteries (atherosclerosis). High blood pressure can occur as a result of your heart having to work harder to pump blood.

How High Cholesterol Influences High Blood Pressure

• High cholesterol influences blood pressure by causing changes in your arteries.

• When LDL (bad cholesterol) builds up in your bloodstream, it forms into plaque that thickens the inner vessel walls, causing your arteries to stiffen, constrict, and lose flexibility over time.

• As a result of these changes, your heart must work harder to pump blood through narrower vessels, causing your blood pressure to increase.

• If not treated, high blood pressure damages artery walls, promoting a hazardous cycle of narrowing and cholesterol build-up.

• While each problem can increase your risk of heart attack and stroke, they pose a significantly higher cardiovascular threat when combined.

Mechanism Behind the Interaction

• Research indicates that high cholesterol plus high blood pressure damages the inner lining of blood vessels (endothelium).

• In an extensive study in males, the risk of high blood pressure aligned with an increase in total cholesterol, LDL (bad) cholesterol, or non-HDL cholesterol, even when adjusting for other factors.

• Both high cholesterol and high blood pressure create an environment that promotes inflammation, plaque formation, and atherosclerosis.

• High cholesterol allows LDL to penetrate the damaged lining and accumulate, forming plaques, which harden and narrow the arteries.

• High blood pressure puts mechanical stress on the endothelium, leading to tears and damage, where more cholesterol can accumulate.

Why the Interaction Matters

Long-term research shows a strong correlation between having high cholesterol and a risk of high blood pressure. In a cohort of over 3,000 men followed for 14 years, researchers reported the following observations:

• Men with the highest total cholesterol had a 23% higher risk of developing high blood pressure than those with the lowest total cholesterol.

• When total cholesterol minus HDL was considered, the risk of high blood pressure increased to 39% in men with the highest levels.

• When unfavorable ratios of total cholesterol to HDL cholesterol were considered, those with the least favorable ratios had a 54% higher risk of high blood pressure.

• In contrast, a 32% decreased risk of hypertension was linked with high HDL (good cholesterol) compared to those with the lowest HDL levels.

This interaction of high cholesterol and a risk of high blood pressure seemed consistent in both sexes (males and females).

• In a separate study comparing the incidence of high cholesterol and high blood pressure in women, a higher risk of high blood pressure was found among healthy women with elevated cholesterol levels.

Other studies show a compounding effect of high cholesterol and high blood pressure.

• The combination of these conditions increases the long-term risk of coronary heart disease mortality, even in young adults, to a higher risk than exists for either factor alone.

• Overall, this risk leads to a higher chance of developing coronary heart disease-related death over a person's lifetime when high cholesterol levels are combined with high blood pressure.

Prevention and Management Strategies

Protecting your heart health can help you prevent or manage elevated cholesterol and blood pressure levels. The American Heart Association recommends the following comprehensive approach to addressing these and other cardiovascular risk factors:

• Eat a heart-healthy diet. Fruits, vegetables, whole grains, fish, poultry, nuts, and non-tropical vegetable oils are all crucial components of a heart-healthy diet. This diet also involves limiting sodium, red and processed meats, and food and beverages with added sugar. Many eating plans, such as the DASH diet (Dietary Approaches to Stop Hypertension), follow these guidelines.

• Prioritize exercise. A heart-healthy lifestyle includes 75 minutes of intense aerobic exercise or 150 minutes of moderate-intensity physical activity weekly. Combine these activity goals with muscle- and bone-strengthening activities at least three days per week for a comprehensive approach to movement and exercise.

• Limit alcohol and eliminate tobacco products. Limit your intake of alcoholic beverages. Don't smoke, vape, or use any other type of tobacco product, which can compound the dangers of other cardiovascular disease risk factors. If you don't smoke, avoid exposure to secondhand smoke when possible.

• Establish and maintain a healthy weight. Please consult your healthcare provider for advice on your target weight and ways to achieve it. Losing as little as 5% to 7% of your body weight may help improve your cholesterol levels and other cardiovascular disease risk factors.

• Work with your healthcare team to establish and follow a treatment plan. Establish a relationship with a trusted healthcare provider who can help you determine and manage your risk of high cholesterol and high blood pressure. When necessary, take medications as prescribed and follow up with the recommended schedule of office visits and tests.