Having one risk factor for heart disease means you need to be careful. Having two means you need to make some significant changes in your life.

Scientists have found that when people have more than one risk factor, like high blood cholesterol and high blood pressure, these factors work together to make risk of heart disease much worse.

Even if your cholesterol and blood pressure levels are only mildly elevated, when they are both present in your body, they can interact with each other to more quickly damage your blood vessels and your heart. If not controlled, they eventually set the stage for heart attack and stroke, as well as other problems like kidney malfunction and vision loss.

If you’ve already been diagnosed with high blood cholesterol, watch those blood pressure numbers like a hawk! These two risk factors like to hang out together. But if you’re aware of what’s happening, you can win the battle for your health.

Understanding high cholesterol

If you’re diagnosed with high cholesterol, it means that the level of cholesterol in your blood is higher than what is believed to be healthy. Cholesterol is a type of fatty substance that your body uses to make certain hormones, produce vitamin D, and build healthy cells. We manufacturer some of it in our bodies and get some of it from the foods we eat.

Too much cholesterol in your blood, though, may increase risk of cardiovascular disease, heart attack and stroke. The concern is that if your cholesterol is high, the excess oily stuff will stick to the walls of your arteries. Over time, this excess can create a fatty buildup, much like dirt and grime can build up inside a garden hose.

The fatty substance eventually hardens, forming a type of inflexible plaque that damages the arteries. They become stiff and narrowed, and your blood no longer flows through them as easily as it once did.

The ultimate danger is that your arteries will become so narrowed that a blood clot will block blood flow, causing a severe cardiovascular event.

What constitutes a high cholesterol level

Doctors use several numbers when determining the status of your cholesterol. According to the National Heart, Lung, and Blood Institute, these are the current guidelines:

Total cholesterol:

healthyless than 200 milligrams per deciliter (mg/dL)
borderline high200 to 239 mg/dL
high240 mg/dL and above
 

Low-density lipoprotein (LDL), or “bad” cholesterol — the type of cholesterol that builds up in arteries:

healthyless than 100 mg/DL
OK100 to 129 mg/DL
borderline high130 to 159 mg/DL
high160 to 189 mg/DL
very high190 mg/DL and above
 

High-density liproprotein (HDL), or “good” cholesterol — the type that helps remove cholesterol from arteries:

healthy60 mg/dL or higher
okay41 to 59 mg/dL
unhealthy40 mg/dL or lower
 

As to what causes high cholesterol, a number of factors may be involved. Diet, weight, and physical activity can affect cholesterol levels, but so can genes, age, and gender.

How high cholesterol can lead to high blood pressure

If you’ve been diagnosed with high blood cholesterol, you may already be taking medications to control it, and you may have made some lifestyle changes to help lower your cholesterol levels naturally.

Meanwhile, it’s important to keep an eye on your blood pressure. People living with high blood cholesterol often end up dealing with high blood pressure as well.

Why would that be? First, let’s look at what high blood pressure is. The American Heart Association states that high blood pressure (or hypertension) is when “the force of your blood pushing against the wall of your blood vessels is consistently too high.”

Imagine that garden hose again. If you’re out watering your small plants, you may turn the water on at low pressure so you don’t damage the tender blooms. If you’re watering a line of shrubbery, though, you may turn up the water pressure to get the job done faster.

Now imagine that garden hose is several years old and full of grit and grime. It’s also a bit stiff with age. To get the water to come through at the pressure you’d like, you have to turn up the faucet to high. The higher pressure helps the water blast through all that gunk inside your hose so you can still use it to water your plants.

If you have high blood pressure, your heart and your arteries go through a similar scenario. Because the arteries are stiff or narrowed — perhaps because of high cholesterol buildup — your heart has to work harder to pump the blood through them.

It’s like your heart has to turn its faucet up to high and blast the blood through to get enough oxygen and nutrients out to all the body organs that need it.

High blood pressure and cholesterol work together to damage arteries

Over time, this high pressure damages your arteries and other blood vessels. They just aren’t built to manage a constant high-pressure blood flow. As a result, they start to suffer from tears and other types of damage.

Those tears make nice resting places for excess cholesterol. That means that the damage high blood pressure creates inside arteries and blood vessels can actually lead to even more plaque buildup and artery narrowing because of high blood cholesterol. In turn, your heart has to work even harder to pump blood, putting excess strain on your heart muscle.

The two conditions are like a team of villains working together to make things worse for your heart, arteries, and overall health. Indeed, over time, high blood pressure and cholesterol can cause problems in your eyes, kidneys, brain, and other organs as well.

Studies reveal an unhealthy partnership

Researchers have known for a while that high blood cholesterol can lead to high blood pressure. In 2002, they separated participants into three groups according to their cholesterol levels (low, medium, and high). They then tested blood pressure under various conditions of rest and exercise.

The results, which were published in the Journal of Human Hypertension, showed that those with higher cholesterol levels had significantly higher blood pressure levels during exercise than those with lower cholesterol levels. The researchers concluded that even mildly increased cholesterol levels could influence blood pressure. They added that cholesterol seems to mess up how blood vessels contract and release, which can also affect the pressure needed to push blood through them.

A later study, published in the Journal of Hypertension, found similar results. Researchers analyzed data from 4,680 participants aged 40 to 59 years from 17 different areas in Japan, China, the United Kingdom, and the United States. They looked at blood pressure, cholesterol levels, and diet over the previous 24 hours. The results showed that cholesterol was directly related to blood pressure for all participants.

In fact, it seems that the presence of high blood cholesterol may actually predict a future presence of high blood pressure. That’s what researchers reported in a 2005 study in Hypertension. They analyzed data from 3,110 men who had not been diagnosed with hypertension or cardiovascular disease at the start, and followed them for about 14 years. Just over 1,000 of them developed hypertension by the end of the study.

Results showed the following:

  • Men with the highest total cholesterol had a 23 percent increased risk of developing hypertension compared to those with the lowest total cholesterol.
  • Men who had the highest levels of total cholesterol minus HDL cholesterol had a 39 percent increased risk of developing hypertension.
  • Men who had the most unhealthy ratio of total cholesterol to HDL cholesterol had a 54 percent increased risk of developing hypertension.
  • Men who had the highest levels of HDL cholesterol had a 32 percent lower risk of developing hypertension.

The same researchers did a similar test on women with a follow-up of about 11 years, and found comparable results. Their study was published in JAMA. Healthy women with higher levels of cholesterol were more likely to develop hypertension down the road than those with lower levels of cholesterol.

Take steps to control both risk factors

The good news is that both of these risk factors are very manageable. Medications are available that are effective at keeping both high cholesterol and high blood pressure under control. The important thing is to stay in communication with your doctor, and to watch your numbers carefully.

You can also adopt lifestyle changes that can naturally fortify your heart and blood vessels and help you resist any damaging effects. Try these tips:

  • Don’t smoke or quit smoking.
  • Stay active — exercise at least 30 minutes a day, and work some resistance training in two times a week.
  • Eat a healthy diet that includes lots of whole grains, fruits, vegetables, lean proteins, and healthy fats like those found in fish and nuts.
  • Avoid excess cholesterol in food, excess fatty foods, excess sodium, and excess sugar.