A stress, blood pressure, and cholesterol link - Brief Article

Harvard Health Letter, Oct, 1997

Forty percent of people with hypertension (blood pressure of 140/90 mm Hg or greater) also have high blood levels of cholesterol (above 240 mg/dl). Although both conditions are risk factors for coronary artery disease, how they are linked to each other is unclear.

Now, a small study has found that people with high cholesterol levels can experience significant increases in blood pressure in response to stress and that lowering cholesterol helps to control blood pressure.

Researchers from the State University of New York at Buffalo studied 33 men and women with normal cholesterol readings and 37 with high levels. Initially, neither group was hypertensive. Participants were given an oral math exam and asked to provide answers as quickly and accurately as possible. During the test, the investigators electronically measured the blood pressures of both groups.

The systolic or top number -- which measures the arterial pressure when the heart contracts -- rose into the hypertensive range in 43% of those with high cholesterol compared to 16% in the normal cholesterol group. Those with the highest levels of cholesterol experienced the greatest spikes in blood pressure.

The high cholesterol group was then placed on a low-fat diet and prescribed 20 mg a day of lovastatin (Mevacor), a cholesterol-lowering drug. After six weeks, cholesterol levels fell an average of 26%. When the group was given another math test, their blood pressure changes were comparable to those initially observed in the participants with normal cholesterol levels.

Because stress-induced rises in blood pressure have been shown to predict the future development of hypertension, people who know they have this condition should check their blood pressure with a home monitor (see Harvard Health Letter, July 1997) as well as schedule regular visits with a physician. Depending on the individual, medications may or may not be needed.

Those with high cholesterol should make sure the problem is treated with a low-fat diet, drugs, or a combination of the two and that blood pressure is monitored regularly. (American Journal of Hypertension, June 1997, pp. 592-599.)