All About Cholesterol and High Blood Pressure

May 14, 2023

Dr. Rosanel with patient

If you’re an adult visiting the doctor for a checkup, two items will almost certainly be on the agenda: your cholesterol and blood pressure. You might even know a bit about what these things are.

There’s “good” and “bad” cholesterol — even TV commercials tell us that. But which kind is which? And how do you keep the levels in a safe range?

When it comes to blood pressure, you may know that it shouldn’t be too high, but how do you keep your blood pressure at a healthy level? And how do blood pressure and cholesterol relate to each other for heart health?

Despite how commonly discussed they are, cholesterol and blood pressure aren’t as simple as they may seem. They’re both key factors in heart health, and keeping their levels in check can help fend off the worst cardiac conditions, such as heart disease or stroke.

Let’s review some of the basics of blood pressure and cholesterol, how they’re related and how to keep their levels in a healthy range.

What is cholesterol?

Simply put, cholesterol is a waxy substance that’s in every cell in the body, according to MedlinePlus. Bodies need some cholesterol, and they get it from certain foods and the liver, which makes it. Certain diets can cause too much cholesterol in the blood.

As mentioned above, there are two primary types of cholesterol. They’re named for proteins in blood called lipoproteins, which transport cholesterol in the body:

  • LDL (low-density lipoprotein) cholesterol: This one is the “bad” cholesterol because it can cause plaque buildup in blood vessels, increasing heart disease and stroke risk, according to the Centers for Disease Control.
  • HDL (high-density lipoprotein) cholesterol: The “good” kind, HDL cholesterol takes cholesterol from the blood back to the liver, which then “flushes it from the body,” the CDC says. High HDL cholesterol can be a good thing, lowering heart disease and stroke risk.
  • Triglycerides: These are a type of fat circulating in the blood that are often mentioned alongside cholesterol levels. When combined with unhealthy cholesterol levels, high triglyceride levels can increase heart attack and stroke risk.

Cholesterol and Your Heart Health

Learn about good and bad cholesterol for your heart health.

What is high blood pressure?

Let’s start with the basics. Blood pressure is measured in two numbers:

  • Systolic blood pressure: This is the first or top number (when, for example, a doctor says your blood pressure is “120 over 80”). It indicates the pressure that your blood is making against your artery walls during heart beats.
  • Diastolic blood pressure: The second, bottom number shows the blood’s pressure against arteries between beats, when the heart is resting.

Both these numbers are measured in millimeters of mercury, or mm Hg. A normal reading is typically less than 120 mm Hg for systolic blood pressure and less than 80 for diastolic. The American Heart Association has an informative graphic showing which levels are considered normal, elevated and high — the last of which doctors also call hypertension.

While blood pressure levels change over the course of a day, it’s a health risk to have consistently high blood pressure. It increases your risk for other issues including heart disease, stroke and heart attack. In addition to affecting the heart, high blood pressure can cause problems throughout the body including in the brain, kidneys and eyes, according to the CDC. High blood pressure is also linked to decreased cognitive function and dementia.

High Blood Pressure

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How are high cholesterol and high blood pressure related?

More than 60 percent of people who have high blood pressure have high cholesterol levels, too, according to WebMD. Both conditions pose risks for the heart and cardiovascular system.

They also work against each other: When cholesterol builds up along arteries, indicating high cholesterol, the arteries become stiff and narrow. This makes it more difficult for the heart to pump blood, so it must work harder, causing blood pressure to increase. High blood pressure can also damage artery walls, tearing them and creating places for cholesterol to build up.

Fortunately, because cholesterol and blood pressure are so intertwined, so are the ways of maintaining healthy levels of each.

How do I maintain healthy cholesterol and blood pressure levels?

There’s a clear, simple list of dos and don'ts for managing your cholesterol and blood pressure. While some people can benefit from medication to help manage their cholesterol or blood pressure, addressing any issues will likely begin with lifestyle and dietary changes. These are also good rules to live by, even if you have healthy levels.

  • Cut back on saturated fats: These foods include animal products like meat, cheese and other dairy products, as well as tropical oils like palm oil. The CDC says these types of foods can have high cholesterol levels.
  • Limit salt and eat more potassium: Excessive sodium increases blood pressure. And not getting enough potassium — a mineral found in bananas, potatoes, beans, yogurt and other foods — can also increase blood pressure.
  • Eat more fiber and more healthy plant fat: Foods like oatmeal and beans are high in fiber. And foods like vegetable oils, nuts and avocados are low in unsaturated fats. Both can help prevent and manage high levels of “bad” cholesterol” while increasing “good” cholesterol, the CDC says.
  • Exercise: Getting two hours and 30 minutes of moderate exercise every week can help lower your cholesterol and blood pressure, according to the CDC. It also helps you maintain a healthy weight, which is important for your body to use cholesterol properly and remove the “bad” kind from your blood.
  • No smoking: It hurts your blood vessels and makes it easier for plaque to build up, the CDC says. Smoking can also lower your “good” cholesterol levels. Tobacco smoking also reduces the amount of oxygen in your blood, increasing high blood pressure risk.
  • Keep track of your family history: Poor cholesterol levels can run in the family — it’s called “familial hypercholesterolemia,” an inherited, genetic mutation that makes it more difficult for your body to remove “bad” cholesterol from your blood. This allows plaque to build up in your blood vessels from a young age, according to the American Heart Association. If your family members have had serious heart problems before age 55 for men or 65 for women, tell your doctor and have your cholesterol levels checked often.

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