High cholesterol means your total cholesterol is 200 mg/dL or higher or your low-density lipoprotein (LDL) cholesterol is higher than 130 mg/dL.
Cholesterol is an essential viscous and fatty substance in the blood. However, when levels are too high, it may increase your chance of cardiovascular disease. This is particularly the case with LDL, often called “bad” cholesterol, because it can build up in your arteries and slow blood flow to the heart and brain.
High-density lipoprotein (HDL), or “good” cholesterol, helps the body reduce the blood levels of LDL. Levels above 40 mg/dL are recommended.
Total cholesterol is the total amount of cholesterol in your blood, including LDL, HDL, and triglycerides.
High total cholesterol readings may result from low physical activity, obesity, smoking, and eating fatty foods.
Can stress cause high cholesterol?
Stress may contribute to high cholesterol, especially spikes in LDL cholesterol, in people who may live sedentary lives and have a diet high in fatty foods and low in nutrient-dense foods.
A 2017 study of 5,000 adults that stretched over 11 years looked at the effect of occupational physical and psychological stress on cholesterol levels.
Although no causal relationship was established, the authors found that psychological stress strongly contributed to high LDL and triglyceride levels and low HDL levels. Regular physical activity and stress management strategies reduced this effect.
A 2021 study of nearly 20,000 nurses and nurse practitioners in Taiwan found that overall stress levels may increase the chances of high cholesterol, blood sugar, and blood pressure. Other factors included age, work hours, and caring for family members in addition to job duties.
Another 2021 study with office workers found a link between high stress, high LDL, and lower HDL levels.
Although more research is needed to determine if overall stress causes high cholesterol, research does indicate that they are often associated.
How stress affects your body
At a glance, this is how your stress response works:
- You perceive a threat.
- Your amygdala — a region of your brain that helps you process emotions and fear — tells your sympathetic nervous system to get your body ready to respond.
- Your adrenal glands receive the message and start releasing adrenaline and cortisol.
- These “stress hormones” increase your heartbeat and breathing rhythm, which leads to more blood flowing toward your muscles and brain.
- You become more sensitive to stimuli and are more alert and ready for the threat by either facing or fleeing it.
The stress response is natural and essential. All types of stressors — real or perceived — may activate this response. It is designed to help you prepare for threats. However, when this stress response is persistently activated, your body stays alert, which may affect body functions.
A 2021 study indicated that stress hormones can negatively impact the cardiovascular system. The higher the level of stress hormones, the higher the chance participants had cardiovascular health challenges.
For instance, over the course of 6.5 years, participants who experienced high stress levels had a greater chance of high blood pressure readings. The readings were related to more stress hormones in the urine, including norepinephrine, epinephrine, dopamine, and cortisol. The participants also had higher levels of cortisol and an increased incidence of heart attacks over the course of 11.2 years.
Psychological stress may also have an immediate effect on your body and cholesterol profile. A 2015 study on undergraduate students explored their physiological response to a written examination. Results indicated that students showed increased blood levels of cortisol, adrenaline, and total cholesterol during the examination.
In the same way, study authors reported that anticipatory stress about the examination increased participants’ cortisol blood levels and total cholesterol over HDL ratio (TC/HDL) before taking the test. TC/HDL is considered a cardiac risk factor.
Does managing stress help lower cholesterol?
The evidence is limited regarding the protective effect of stress management on cholesterol levels. Based on what the research suggests, though, reducing stress levels may help you decrease the chance of cardiovascular complications.
The American Heart Association recommends stress management to improve heart health, including:
- getting regular exercise
- managing time effectively
- not acquiring too many commitments (learning to say “no”)
- having an active social life
- engaging in relaxation techniques
How is high cholesterol treated?
Chronic high cholesterol often requires medical intervention. Your healthcare professional may recommend statins, a group of drugs designed to reduce cholesterol blood levels. These may include:
- atorvastatin (Lipitor)
- fluvastatin (Lescol)
- lovastatin (Altoprev)
- pravastatin (Pravachol)
- rosuvastatin (Crestor)
- simvastatin (Zocor)
Other medications to reduce cholesterol absorption may include:
- bile acid sequestrants, like colestipol (Colestid)
- adenosine triphosphate-citrate lyase (ACL) inhibitors, like bempedoic acid (Nexletol), and bempedoic acid with ezetimibe (Nexlizet)
- fibrates, like gemfibrozil (Lopid) and clofibrate (Atromid-S)
Prevention and management strategies may also involve:
- weight management
- not smoking
- regular physical activity
- a diet low in saturated and trans fats
- a diet high in fiber, fruits, vegetables, nuts, and fatty fish
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