High blood pressure and high cholesterol
Hypertension, high LDL cholesterol, cardiovascular risk
Chronic conditionBlood pressure that stays at 130/80 or higher, and LDL cholesterol that stays high, both raise your risk of heart attack and stroke. Neither usually causes symptoms, so testing is the only way to know.
Medical Disclaimer
For education only — this guide can't diagnose you. If these signs sound familiar, talk with a healthcare provider. Book a consult
What happens
High blood pressure strains the walls of your arteries and makes your heart and kidneys work harder. Over time it can damage the small vessels in the kidneys, eyes, and brain. High LDL and other cholesterol-carrying particles build up in artery walls and form plaque. The two often travel together with insulin resistance and belly fat, and each one adds to the other's risk. The liver makes most of your cholesterol, and fatty liver disease often goes along with high triglycerides. Some people inherit high cholesterol or a high level of lipoprotein(a), a particle that raises risk regardless of lifestyle.
Who gets it
Risk climbs after menopause, when blood pressure and LDL often rise. A history of preeclampsia, high blood pressure in pregnancy, or gestational diabetes raises lifelong heart risk. PCOS, early menopause, and autoimmune diseases such as lupus and rheumatoid arthritis do too. Family history, smoking, kidney disease, and some medicines, including certain birth control pills, also play a part.
Signs worth getting checked
- Usually no symptoms at all
- Readings at or above 130/80 on a home or office monitor
- Headaches, usually only when blood pressure is very high
- Shortness of breath or chest pressure with exertion, a sign of heart disease
- Swelling in the legs or feet
- Yellowish bumps on the eyelids, elbows, or tendons with very high cholesterol
- A gray or white ring around the colored part of the eye before age 45
Labs to ask about
- Home blood pressure readings with a validated upper-arm cuff, taken over a week
- Lipid panel: LDL, HDL, triglycerides, and non-HDL cholesterol
- ApoB, which counts the cholesterol-carrying particles
- Lipoprotein(a), measured once in your lifetime
- A1c or fasting glucose
- Kidney function (creatinine and eGFR) and a urine albumin test
Treatments your doctor may discuss
- The DASH diet, which lowers blood pressure about as much as one medicine
- A Mediterranean-style diet, which lowers heart attack and stroke risk
- Blood pressure medicines when readings stay high, often started at low doses and combined
- Statins or other cholesterol medicines based on your overall risk, not just one number
- Treating related conditions such as sleep apnea, insulin resistance, or thyroid disease
Supportive steps to discuss with your provider
- Check your blood pressure at home, seated and rested, and bring your log to visits.
- Cut back on salt and eat more potassium-rich foods such as vegetables, fruit, and beans, unless you have kidney disease.
- Aim for at least 150 minutes of brisk activity a week, plus strength training.
- Limit alcohol and don't smoke.
- Tell every provider about any pregnancy complications. They count toward your heart risk.
See a doctor promptly if you have
- Chest pain or pressure, sudden shortness of breath, or face drooping, arm weakness, or trouble speaking: call 911
- Blood pressure of 180/120 or higher with a severe headache, vision changes, or confusion: call 911
- Blood pressure of 160/110 or higher during pregnancy or in the weeks after birth: go to the emergency room
- Home readings that stay at 130/80 or higher
- New leg swelling or foamy urine
Related conditions
Ready to find the root cause?
Dr. Lesher is a Naturopathic Doctor who focuses on autoimmune and chronic conditions in women. Since 2020, she's helped hundreds of patients stop managing symptoms and start healing.