A person can have high cholesterol and low blood pressure at the same time due to certain medications, underlying health conditions, or lifestyle factors, including diet.

Blood cholesterol and blood pressure are two different but important factors in reducing a person’s risk of heart disease and stroke.

Cholesterol is a waxy substance that moves around the body in the blood. Certain types of cholesterol cling to the artery walls, and these include low-density lipoprotein (LDL) cholesterol and triglycerides. Other types, such as high-density lipoprotein, take cholesterol to the liver, where it breaks down, helping manage cholesterol levels.

Blood pressure refers to the force of the blood pushing against blood vessel walls as it moves around the body. Factors such as how narrow or blocked the arteries are can lead to changes in blood pressure. This has links to increased LDL cholesterol, but it is ultimately a separate measurement of health and cardiovascular disease risk.

This article explains how some people can have high cholesterol and low blood pressure at the same time.

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Cholesterol levels and blood pressure are different mechanisms in the body. However, they both relate to cardiovascular disease risk, which indicates someone’s likelihood of developing heart disease or stroke.

High cholesterol for a long period can lead to fatty deposits building up on the walls of major arteries. This causes atherosclerosis, a condition that stiffens the artery walls.

High blood pressure can make this worse. According to a 2021 review, high cholesterol and blood pressure may greatly increase a person’s risk of a heart attack.

A 2021 study of data from over 45,000 people found that high cholesterol may increase the risk of high blood pressure due to stiffened arteries. Cholesterol and blood pressure may move in different directions depending on a range of health factors.

In some people, high cholesterol may occur at the same time as low blood pressure. Even though those with high cholesterol may have an increased risk of high blood pressure, they are separate processes that different factors may affect.

Low blood pressure might occur for several reasons, including:

On the other hand, high cholesterol can pass from parents to children in the genes. It can also develop due to lifestyle factors, such as:

  • a diet high in fatty foods
  • low levels of daily exercise
  • having overweight or obesity
  • smoking
  • drinking excessive amounts of alcohol

Medication side effects

Some medications to treat one of these conditions may cause the other.

For example, people may take a diuretic medication called hydrochlorothiazide to treat high blood pressure. This may cause low blood pressure as an adverse effect. However, according to a 2018 paper, high dose thiazides can lead to a temporary spike in LDL cholesterol and triglycerides.

During this spike, a person may experience low blood pressure and high cholesterol at the same time.

Underlying health conditions

Several health conditions increase a person’s risk of having high cholesterol and low blood pressure simultaneously.

Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormone. This can affect how the body controls blood fat levels and has links to low blood pressure.

Adrenal insufficiency occurs when the adrenal glands do not produce enough adrenaline. This may cause high cholesterol and low blood pressure as symptoms.

Lifestyle factors

Different lifestyle factors can cause high cholesterol but low blood pressure. For example, people with a severe or rapid drop in blood sodium due to drinking too much water might experience low blood pressure. However, if the same person eats a high fat diet, they might also have high cholesterol.

Several lifestyle factors can reduce both blood pressure and cholesterol levels. These include:

  • maintaining a moderate weight
  • exercising regularly
  • quitting or avoiding smoking, if applicable
  • reducing alcohol intake

People can reduce cholesterol levels by eating less food containing saturated fat. Cutting down on caffeine and salt content in foods might also help a person’s blood pressure.

Those who receive a diagnosis of high blood pressure or high cholesterol might receive medications to control either.

The following are answers to some questions people frequently ask about high cholesterol.

Can a person have high cholesterol and still be healthy?

People need cholesterol to live. High levels of LDL cholesterol can increase heart disease and stroke risk, but individuals can still be healthy with these high levels.

What are the five signs of high cholesterol?

High cholesterol does not usually cause symptoms. Regular cholesterol tests are important for monitoring cholesterol levels and identifying an increased risk of heart attack and stroke.

People can have high cholesterol and low blood pressure at the same time. They are separate mechanisms that often relate to one another but can change independently.

Certain underlying conditions, medication side effects, and lifestyle factors can mean that a person has high cholesterol but low blood pressure.

For people who have high cholesterol, blood pressure changes, or both, managing cholesterol levels and blood pressure is vital for reducing the risk of heart disease. This is possible through exercise, diet, smoking cessation, or prescribed medications.