Does High Cholesterol Cause High Blood Pressure?

Marie-Claire de Villiers
By Marie-Claire de Villiers
Joel Taylor
Edited by Joel Taylor

Published June 30, 2022.

Female lying in the bed while measuring high blood pressure

High cholesterol and high blood pressure are the primary causes of heart disease. Many people find heart problems difficult to understand, and this comes as no surprise, as the two main contributors seem to be inextricably linked while still holding equal importance as individual factors.

Relationship Between High Cholesterol and Blood Pressure

Researchers are still trying to figure out exactly how high cholesterol and high blood pressure interact. What is known is that they seem to feed off each other or increase each other's levels—worsening heart disease significantly.

Blood pressure may drop when cholesterol decreases. However, this has to be done through lifestyle changes such as following a healthy diet and getting regular exercise. Medication that lowers cholesterol seems to not make much difference in blood pressure.

The most important thing to know about these problems is that, even though they have a link to each other, they must be treated individually—and separate medications are needed for each condition.

Having one of these problems is a risk, but if you have both, you may need to make some significant lifestyle changes.

Is High Cholesterol a Comorbidity?

In certain diseases or conditions, high cholesterol is a comorbidity. This is especially the case in conditions that trigger inflammation in the body, such as Lupus.

High Cholesterol and COVID-19

COVID-19 creates a pro-inflammatory state, and if you have high cholesterol, your risk of a cardiovascular event is greatly increased. The risks are increased even further by obesity.

How High Cholesterol Leads to High Blood Pressure

Excess cholesterol sticks to the artery walls like plaque, making them more narrow and stiff. The heart has to work harder to pump blood through them, causing heightened blood pressure. High blood pressure also has its own negative effect on arteries—sometimes creating tears in the walls. Excess cholesterol collects in these tears, too.

Higher cholesterol would lead to higher blood pressure which could, in turn, lead to a further increase in cholesterol levels.

Can You Have Normal Blood Pressure With High Cholesterol?

It is possible to have normal blood pressure and high cholesterol. If blood pressure is normal or even a bit low, it doesn't counteract the heart disease risks of having high cholesterol. This is one of the reasons they need to be treated separately.

Cholesterol-Raising Factors Beyond Your Control

Unfortunately, there are some contributing factors beyond your control. Primary among these is genetic predisposition, although it should be noted that, just because an older family member has high cholesterol or high blood pressure, doesn't necessarily mean you will. The lifestyle choices mentioned below play a large role and may help prevent these issues.

Age is another factor to consider as older people are more at risk.

Additionally, it's essential to learn the differences between different things that can lead to high cholesterol, such as hypercholesterolemia vs. hyperlipidemia.

How to Manage High Cholesterol and High Blood Pressure

Lifestyle Changes

The first port of call in managing high cholesterol and high blood pressure is looking at some of the major lifestyle habits which tend to cause these problems and identifying where change is needed. Studies suggest that the following factors can contribute to high blood pressure (1)(2):

  • Smoking cigarettes
  • Eating foods high in saturated fats
  • Being overweight
  • Being inactive
  • Drinking large amounts of alcohol
  • excessive stress

In addition, the American Heart Association (AHA) recommends a diet high in fruits, vegetables, beans, nuts, and whole grains.


In some cases, lifestyle changes are not enough, and medication is needed—this medication will differ from person to person. When talking to your doctor, make sure to tell them about your lifestyle.

Commonly prescribed classes of medications for high cholesterol include:

  • Statins
  • Niacins
  • Fibrates
  • Resins
  • Cholesterol absorption inhibitors

Commonly prescribed medications for hypertension include:

  • Diuretics
  • Beta-blockers
  • ACE inhibitors
  • Angiotensin II receptor blockers
  • Calcium channel blockers
  • Alpha blockers
  • Alpha-2 Receptor Agonists
  • Combined alpha and beta-blockers
  • Central agonists
  • Peripheral adrenergic inhibitors
  • Vasodilators