Having high cholesterol increases a person’s risk of developing hypertension. These two conditions put a person at risk of cardiovascular complications such as stroke and heart disease.

“Hyperlipidemia” refers to having too many lipids (fats), such as cholesterol and triglycerides, in the body. Nearly 2 in 5 adults in the United States have hyperlipidemia.

High blood pressure (hypertension) is when a person’s blood pressure — the force of blood pushing against the blood vessel walls — is too high. Nearly half of U.S. adults have hypertension.

Hyperlipidemia and high blood pressure are major modifiable risk factors for cardiovascular disease (CVD). Both conditions damage the blood vessels and put the person at risk for cardiovascular complications such as heart attack and stroke.

Read on to learn about the link between hypertension and hyperlipidemia.

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Hypertension and high cholesterol often coexist, possibly because they have the same underlying mechanisms, such as obesity and narrowing of arteries.

Both conditions drive the development of atherosclerosis, the leading cause of CVD.

High blood cholesterol levels can cause plaque buildup in the artery walls. This plaque can stiffen and narrow the blood vessels, which causes the heart to work harder, leading to high blood pressure.

A 2022 study found that people with high blood pressure and overweight or obesity have a higher risk of developing hypertension.

A 2016 study found similar results. Even after adjusting for age, body mass index, smoking, and other factors, the researchers found that people with high total cholesterol and low-density lipoprotein (LDL) and non‐high‐density lipoprotein cholesterol had a significantly higher risk of hypertension.

Learn more about serum cholesterol.

Meanwhile, hypertension increases arterial damage and atherosclerosis through direct mechanical pressure. A 2021 animal study suggests that it also causes structural changes in the blood vessels, leading to the accumulation of cholesterol in the blood vessels.

While having either of these conditions can increase a person’s CVD risk, having both conditions increases it further.

The two conditions have a synergistic effect on ischemic stroke. This means that the combination of the two conditions affects a person’s chance of having a stroke significantly more than the sum of their independent effects.

A 2023 study found that the combination of lipoprotein (a) and hypertension increases a person’s risk of developing CVD and having a major cardiovascular event such as a stroke or heart attack within 14 years.

A similar 2019 study on the associations of blood pressure and cholesterol levels during young adulthood found that elevated blood pressure and LDL had links to increased CVD risks later in life, independent of later adult exposures.

Read about what doctors consider to be high blood pressure.

While a single risk factor increases a person’s total CVD risk twofold to threefold, the coexistence of several risk factors, such as type 2 diabetes, smoking, hypertension, and high cholesterol, can result in a more than 20-fold increase in risk.

Studies show that treating hypertension and high cholesterol together yields a more significant decrease in CVD risk. Below are recommendations for treating both conditions.

Lifestyle interventions may include:

  • getting 3.5–7 hours of aerobic exercise per week
  • reducing intake of salt and saturated fatty acids
  • eating more whole grain products, vegetables, fish, and fruits
  • drinking alcohol in moderation or limiting alcohol intake
  • making efforts to maintain a moderate weight

Food and substances that may help lower blood pressure and blood fat levels include:

Blood pressure-lowering drugs that can also affect blood lipid levels include:

Lipid-lowering substances with effects on blood pressure include:

  • statins
  • omega-3 polyunsaturated fatty acids

Learn more about treatments for hypertension.

High cholesterol does not cause symptoms. Experts recommend that generally healthy adults get their cholesterol levels checked every 4–6 years and that those with a higher risk get checked more often.

If a blood test shows high cholesterol, a doctor may recommend lifestyle changes, medications, or both. They are likely to offer the same recommendations for people with hypertension.

Several other symptoms may accompany the elevated reading, such as:

Hypertension and high cholesterol are two key risk factors for CVD. Having both of these conditions increases a person’s CVD risk more than having either one alone. Each condition also affects the other, and a person with one condition has a higher risk of developing the other.

Treating both conditions through lifestyle changes and medications helps reduce the risk. To further decrease their risk, it is important that a person speak with a doctor about cholesterol and blood pressure tests, especially if they experience symptoms.