High Blood Pressure And High Cholesterol

Both high cholesterol and high blood pressure are significant risk factors for heart disease and stroke on their own. When high cholesterol and high blood pressure occur together, they can damage blood vessels and significantly raise the risk of future complications. 

This article aims to explain what high blood pressure and high cholesterol are, the link between the two conditions, and some preventive measures to reduce your risk of getting them.

There appears to be a complicated interplay between high blood pressure and high cholesterol, read on to learn more.

What is high blood pressure?

Before I dive into what high blood pressure is, let me explain to you what blood pressure and blood pressure readings mean so you can have a rich understanding of the topic.

Blood pressure is a measure of the force that your heart uses to pump blood through your whole body and it is measured in millimeters of mercury (mmHg).1

Your blood pressure reading has two numbers. For example, 120/80, the first one (120) represents systolic blood pressure and the second one (80) represents diastolic blood pressure.2

Your heart squeezes and pushes blood through arteries to the rest of the body. When it beats, this force creates pressure on those blood vessels (arteries), which is the systolic blood pressure. Diastolic blood pressure is the pressure in the arteries when your heart rests between beats and this is when your heart gets filled with blood.2

A normal blood pressure reading should be between 90/60 mmHg and 120/80 mmHg. High blood pressure (hypertension) is blood pressure consistently higher than normal.2Your blood pressure rises and falls throughout the day normally but when it stays high for a long time, it causes your heart to pump harder and work overtime which can lead to serious health problems such as stroke, heart failure, and heart attack.3

Your blood pressure is considered high when your systolic readings are 130 mmHg or higher and/or diastolic readings of 80 mmHg or higher consistently. Below is a blood pressure level classification table sourced from the National Institutes of Health.2,3

ClassificationSystolic blood pressure readingDiastolic blood pressure reading
Normalless than 120 mmHgless than 80 mmHg
Elevated120-129 mmHgless than 80 mmHg
High blood pressure130 mmHg or higher80 mmHg or higher

Signs and symptoms

Hypertension is a silent killer because it may not have any signs or symptoms. Many people with hypertension are not aware of it until it has caused serious health problems. That is the reason it is important to have your blood pressure checked regularly, at least once a year.4,5

Causes and risk factors

In most cases, the exact cause of high blood pressure is not clear. Known causes include having an underlying health problem such as diabetes, glomerulonephritis, kidney disease, lupus, and obstructive sleep apnoea, or taking a particular medication such as steroids and some herbal remedies. It can also be pregnancy induced called gestational hypertension which usually subsides after giving birth.6,7,8,9

Risk factors of high blood pressure include:

  • Being overweight.
  • Inadequate physical activity.
  • Excessive salt intake.
  • Smoking.
  • Age above 65.
  • Family history of high blood pressure.
  • Alcohol and tobacco consumption.
  • Black African or Caribbean race.6


Undiagnosed or uncontrolled high blood pressure can lead to serious complications such as;

  • Eye damage.
  • Stroke.
  • Heart attack.
  • Heart failure.
  • Vascular dementia.
  • Aneurysm.
  • Peripheral artery disease.
  • Kidney failure.2


High blood pressure doesn't usually have any symptoms, the only way to find out if you have it is to get your blood pressure checked. The National Health Service recommends getting it checked at least once every 5 years and once every year for people at an increased risk of high blood pressure.5

You can get your blood pressure checked by your GP, at a pharmacy, or by buying a digital blood pressure machine if you want to regularly check your blood pressure at home after informing your GP.5

It is important to note that having a raised blood pressure reading in one test does not necessarily mean that you have high blood pressure because your blood pressure can fluctuate throughout the day unless subsequent blood pressure readings are consistently high.5

When to see a doctor

Although high blood pressure doesn't usually have symptoms, you should see your doctor to get your blood pressure checked if you have a sudden, severe headache, nosebleed, chest pain, shortness of breath, or visual difficulty.10

What is high cholesterol?

Cholesterol is a naturally produced fatty substance found in your blood. It is produced in your liver in the amount needed by your body. The remaining cholesterol in your body comes from the food you eat (animal sources like meat and poultry). Your body needs it to stay healthy. It is termed "high cholesterol" when there is too much in your blood.11

There are two main types of cholesterol which are High-Density Lipoproteins (HDL) and Non-High Density Lipoproteins (non-HDL).11 

High Density Lipoproteins - HDL: It is known as "good cholesterol", HDL picks up excess cholesterol and returns it to your liver.11

Non-high Density Lipoproteins - non-HDL: This is the bad cholesterol, it was formerly known as Low-Density Lipoproteins but the British Heart Foundation stated that we now know that other forms of non-HDL are harmful. It is called bad because when it is too much, it can build up inside the walls of your blood vessels, clogging them up and causing the arteries to narrow. This can increase your risk of having a stroke or heart attack.11,12,13

Signs and symptoms

High cholesterol usually has no signs or symptoms, you can only find out if you have high cholesterol by checking your blood levels of cholesterol. Your healthcare providers can do a blood test called "lipid profile" to measure your cholesterol levels.14

Causes and risk factors

Eating fatty foods, saturated fats, and trans fats may increase your risks of having high cholesterol, as can smoking and drinking alcohol, older age, a poor diet, not exercising enough, and being overweight.15

A genetic disorder known as familial hypercholesterolemia can cause high cholesterol, this disorder prevents your body from removing the bad cholesterol. Also, medical conditions such as hypothyroidism, lupus, HIV/AIDS, chronic kidney disease, and diabetes can cause unhealthy cholesterol levels in the body.15,16


High cholesterol without treatment can cause cholesterol and other deposits to build up in the walls of your arteries, which can cause the narrowing of your arteries over time. This condition is called atherosclerosis.

Atherosclerosis restricts blood flow through your arteries and can result in life-threatening conditions such as:


To diagnose high cholesterol, your doctor will ask questions based on your family and medical history and carry out a blood test. The blood test is known as a lipid panel. It can also be called a lipoprotein profile or lipid profile.18

When to see a doctor

High blood cholesterol does not have symptoms and the only way to be safe is to regularly get your cholesterol levels checked. 

The National Heart, Lung and Blood institute recommended a guide for cholesterol screening which says screening should begin at ages 9-11 and should be repeated every 5 years. Men aged 45-55 and women aged 55-65 should get screened every 1-2 years. Adults over 65 should get screened every year. Your doctor might recommend getting tested more frequently if you have a family history of high cholesterol, diabetes, and heart disease.18

What is the link between high blood pressure and high cholesterol?

The buildup of cholesterol and calcium in your arteries causes them to become hard and narrow, your heart has to work harder to pump blood through them, and your blood pressure becomes too high as a result, meaning when there is too much cholesterol in your blood, there is an increased risk of high blood pressure.19

In the same way, high cholesterol increases the risk of high blood pressure, high blood pressure also increases the risk of cholesterol buildup. 


Over time, high blood pressure causes small tears in the walls of the blood vessels. Those tears make good resting places for excess cholesterol and this can lead to more plaque buildup and narrowing of the arteries, which in turn puts more strain on the heart and makes it harder to pump blood.20

A 2015 research study done to examine the combined effects of blood pressure and total cholesterol levels on long-term risks for subtypes of cardiovascular death in an Asian population revealed that people with higher blood pressure and higher cholesterol levels had the greatest risk for coronary heart disease death.21

When the risk factors for high cholesterol and high blood pressure occur together, they increase the risk of cardiovascular conditions such as heart attack and kidney malfunction.

It is important to monitor and treat other risk factors when either one of the two is present.

Ways to reduce the risk of getting high blood pressure and high cholesterol

Lifestyle changes

Healthy lifestyle changes can have a huge impact on reducing your risk of getting high blood pressure and high cholesterol. Making these changes can be hard at first, but they would go a long way in helping you have a healthier heart. 

Trying to make all these changes at once can discourage you and make you stop eventually. It is generally advised to start gradually and try to be consistent.

Some changes to be included:

  • Eat fewer processed foods and fried foods.
  • Reduce your salt intake.
  • Stop smoking.
  • Reduce your fast food intake as they contain saturated and trans fat.
  • Increase your physical activity.22,23

Medical interventions

In some cases, lifestyle changes aren't enough to bring cholesterol and blood pressure levels down, your healthcare provider can prescribe medications to manage each condition.

Statins are effective cholesterol-lowering medications. There are many effective and well-tolerated medications for lowering blood pressure as well such as diuretics, beta-blockers, ACE inhibitors, and more. Your healthcare provider can help to decide which medications are appropriate for you.24,25

Other ways

Other preventive measures include:

  • Get a good night's sleep.
  • Reduce stress.
  • Limit alcohol intake.
  • Eat a healthy diet.
  • Monitor your blood pressure and cholesterol levels regularly.22,23


High blood pressure and high cholesterol each increase the risk of cardiovascular conditions such as heart attack and stroke. Having high cholesterol and high blood pressure together further increases these risks.

It is important to regularly get your blood pressure and cholesterol levels checked, lead a healthy lifestyle, and take medications to lower blood pressure and cholesterol if prescribed by your healthcare provider. These are two serious conditions but taking the necessary steps to prevent and manage them can go a long way in reducing your risks of life-threatening complications.


  1. What is blood pressure? [Internet]. NHS.UK. 2018 [cited 2022 Oct 7]. Available from: https://www.nhs.uk/common-health-questions/lifestyle/what-is-blood-pressure/
  2. High blood pressure (Hypertension) [Internet]. NHS.UK. 2017 [cited 2022 Nov 3]. Available from: https://www.nhs.uk/conditions/high-blood-pressure-hypertension/ 
  3. High blood pressure - what is high blood pressure (Hypertension) | NHLBI, NIH [Internet]. [cited 2022 Nov 4]. Available from: https://www.nhlbi.nih.gov/health/high-blood-pressure
  4. Hypertension [Internet]. [cited 2022 Nov 4]. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension 
  5. High blood pressure - diagnosis | NHLBI, NIH [Internet]. [cited 2022 Nov 4]. Available from: https://www.nhlbi.nih.gov/health/high-blood-pressure/diagnosis 
  6. High blood pressure (Hypertension) - Causes [Internet]. NHS.UK. 2017 [cited 2022 Nov 4]. Available from: https://www.nhs.uk/conditions/high-blood-pressure-hypertension/causes/ 
  7. High blood pressure - pregnancy and high blood pressure | NHLBI, NIH [Internet]. [cited 2022 Nov 4]. Available from: https://www.nhlbi.nih.gov/health/high-blood-pressure/pregnancy 
  8. Glomerulonephritis [Internet]. NHS.UK. 2017 [cited 2022 Oct 17]. Available from: https://www.nhs.uk/conditions/glomerulonephritis/
  9. Lupus [Internet]. NHS.UK. 2017 [cited 2022 Nov 4]. Available from: https://www.nhs.uk/conditions/lupus/ 
  10. High blood pressure - symptoms and treatment [Internet]. [cited 2022 Nov 4]. Available from: https://www.bhf.org.uk/informationsupport/risk-factors/high-blood-pressure/symptoms-and-treatment 
  11. High cholesterol - causes, symptoms & treatments [Internet]. [cited 2022 Nov 4]. Available from: https://www.bhf.org.uk/informationsupport/risk-factors/high-cholesterol 
  12. CDC. Heart attack symptoms, risk factors, and recovery | CDC. Gov [Internet]. Centers for Disease Control and Prevention. 2022 [cited 2022 Oct 8]. Available from: https://www.cdc.gov/heartdisease/heart_attack.htm
  13. About stroke [Internet]. www.stroke.org. [cited 2022 Oct 8]. Available from: https://www.stroke.org/en/about-stroke
  14. CDC. Get a Cholesterol Test | cdc.gov [Internet]. Centers for Disease Control and Prevention. 2022 [cited 2022 Nov 4]. Available from: https://www.cdc.gov/cholesterol/cholesterol_screening.htm 
  15. High cholesterol - Symptoms and causes [Internet]. Mayo Clinic. [cited 2022 Nov 4]. Available from: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800 
  16. Familial hypercholesterolemia [Internet]. British Heart Foundation. [cited 2022 Oct 9]. Available from: https://www.bhf.org.uk/informationsupport/conditions/familial-hypercholesterolaemia
  17. Arteriosclerosis / atherosclerosis - Symptoms and causes [Internet]. Mayo Clinic. [cited 2022 Nov 4]. Available from: https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569 
  18. Blood cholesterol - diagnosis | NHLBI, NIH [Internet]. [cited 2022 Nov 4]. Available from: https://www.nhlbi.nih.gov/health/blood-cholesterol/diagnosis 
  19. High cholesterol: causes, symptoms and how it affects the body [Internet]. Cleveland Clinic. [cited 2022 Nov 4]. Available from: https://my.clevelandclinic.org/health/articles/11918-cholesterol-high-cholesterol-diseases 
  20. What’s the connection between high blood cholesterol and hypertension? [Internet]. Healthline. 2017 [cited 2022 Nov 4]. Available from: https://www.healthline.com/health/high-cholesterol/treating-with-statins/hypertension 
  21. Satoh M, Ohkubo T, Asayama K, Murakami Y, Sakurai M, Nakagawa H, et al. Combined effect of blood pressure and total cholesterol levels on long-term risks of subtypes of cardiovascular death. Hypertension [Internet]. 2015 Mar [cited 2022 Oct 17];65(3):517–24. Available from: https://www.ahajournals.org/doi/full/10.1161/HYPERTENSIONAHA.114.04639
  22. 10 drug-free ways to control high blood pressure [Internet]. Mayo Clinic. [cited 2022 Nov 4]. Available from: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974 
  23. Can lifestyle changes benefit your cholesterol? [Internet]. Mayo Clinic. [cited 2022 Nov 4]. Available from: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/reduce-cholesterol/art-20045935 
  24. Types of blood pressure medications [Internet]. www.heart.org. [cited 2022 Oct 17]. Available from: https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/types-of-blood-pressure-medications
  25. High cholesterol - Medicines for high cholesterol [Internet]. NHS.UK. 2019 [cited 2022 Nov 4]. Available from: https://www.nhs.uk/conditions/high-cholesterol/medicines-for-high-cholesterol/ 
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Faridah Ojulari

Bachelor of Pharmacy - BPharm, Pharmaceutical Sciences, University of Ilorin

Faridah Ojulari is a Medical Writer and a Bachelor of Pharmacy undergraduate from Nigeria.

She has a burning passion for writing and providing credible medical and health information.

Over the years as a Pharmacy student and medical writer, she has developed strong research, management, and communication skills.

Faridah is an avid learner and has taken various certification courses including research writing in the sciences, content creation, digital marketing, and data analysis.
She strongly believes that the most important skill a person can have is communication.

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