Does Stress Cause High Cholesterol? What the Evidence Shows (UK)

How stress might affect cholesterol

The direct route: stress hormones

When you feel under pressure, your brain tells your body to release hormones such as adrenaline and cortisol. The British Heart Foundation (BHF) explains that these temporarily raise your blood sugar, blood pressure, heart rate and cholesterol. This is the fight or flight response, and it is meant to pass.

Part of that short-term rise isn’t extra cholesterol at all. In a small US lab study, a stressful 20-minute mental task raised total cholesterol by about 0.10mmol/L. Stress also briefly reduced the watery part of the blood, so everything in it looked more concentrated. Once the researchers corrected for that, the change disappeared. Simply standing up raised cholesterol more than the stress task did.

The indirect route: what we do when stressed

This is the bigger effect. The NHS lists eating, drinking or smoking more and poor sleep among the signs of stress (see stress symptoms). The BHF says stress makes us more likely to drink too much, overeat salty, sugary and fatty food, smoke and move less, and that these habits can lead to high cholesterol, high blood pressure and type 2 diabetes.

Poor sleep is part of the same picture. See sleep deprivation.

What the research shows

You can’t ethically keep people stressed for years in a trial, so the evidence comes from short lab experiments and studies that observe people. These can show a link but can’t prove cause and effect.

• UK lab study, 199 adults: researchers at University College London gave middle-aged men and women mildly stressful tasks. Total, LDL and HDL cholesterol all rose afterwards. Three years later, the people whose blood fats had reacted most were more likely to have clinically raised cholesterol, even after allowing for age, weight change, smoking, alcohol and their starting levels.
• Spanish workplace study, 91,593 workers: people reporting job stress had about 14% higher odds of high LDL cholesterol and about 10% higher odds of a current high cholesterol diagnosis. A modest link, from a single snapshot in time.
• Airline pilots: in a US study of 100 pilots, most blood fat measures were higher during a period of heavy work stress than during a quieter period.
• Heart disease, 197,473 people: a large European analysis found job strain was linked to about a 23% higher risk of coronary heart disease. The authors noted that tackling workplace stress would have a much smaller effect than tackling standard risk factors such as smoking.

Our reading: stress is linked to slightly worse cholesterol, the effect is small next to diet, weight, smoking and genes, and much of it probably works through habits. If your result is high, stress is unlikely to be the whole story.

What really causes high cholesterol

The NHS lists eating fatty food, not exercising enough, being overweight, smoking and drinking alcohol as the main causes. You’re also more likely to have high cholesterol if you’re over 50, a man, have been through the menopause, or are of South Asian or sub-Saharan African origin. It can also run in families.

One inherited condition, familial hypercholesterolaemia (FH), can cause extremely high cholesterol. HEART UK says your doctor can test for it, and treatment works best started early.

For women, a midlife rise may be down to the menopause rather than stress.

Stress, cholesterol and blood pressure

The BHF says stress alone will not cause heart and circulatory disease, but long-term stress can affect heart health and raise blood pressure, and it is linked to habits that raise risk. High cholesterol and high blood pressure are both risk factors for heart problems and stroke.

So your GP looks at cholesterol alongside your age, blood pressure, smoking and other factors to give a QRISK score: your estimated chance of a heart or circulation problem in the next 10 years.

How to lower your cholesterol

1. Cut saturated fat. Eat less fatty meat, sausages, pies, butter, lard, ghee, cream, cheese, cakes, biscuits and anything with coconut or palm oil.
2. Add foods that work for you. HEART UK suggests 3g of oat or barley beta-glucan a day, a handful of nuts at least four times a week, and soya foods. See high fibre foods.
3. Move more: at least 150 minutes of moderate activity a week, such as brisk walking.
4. Stop smoking and keep alcohol within 14 units a week.
5. Ask about medicine if needed. Statins reduce the amount of cholesterol your body makes, and you usually take them for life. Whether you need one is a decision for you and your GP, based on your overall risk.

You will see claims about garlic, flaxseed, green tea and apple cider vinegar. Trials show small effects at best, and none replaces the steps above or prescribed medicine. We look at the numbers in garlic and cholesterol, flaxseed and the heart, green tea research and apple cider vinegar and cholesterol.

Managing stress still matters

Even if stress is a small direct factor, it is often the reason the healthy habits slip. A few things that help:

• Find the source. If it’s work, see stress at work and, if you’re struggling to cope, being signed off with stress.
• Protect your sleep and watch the evening drink. See alcohol and sleep.
• Be wary of quick fixes for cortisol. We cover what is real in how to lower cortisol naturally, high cortisol symptoms in women and cortisol belly.
• Watch for burnout. Constant exhaustion and dread are signs to act. See burnout symptoms.

iSee a GP if you’re struggling to cope. In England, adults can also refer themselves to NHS talking therapies without seeing a GP first.

If a calmer evening routine is part of your plan, our Magnesium Glycinate Sleep Complex is a caffeine-free berry drink with magnesium bisglycinate and citrate and L-theanine. Magnesium contributes to normal psychological function and to a reduction of tiredness and fatigue. It won’t lower cholesterol, and it isn’t a treatment for stress. It’s for adults only, and we don’t recommend our products during pregnancy or breastfeeding. If you take a statin or any other medicine, check with your GP or pharmacist first.

The FSA’s 10mg a day figure for CBD is precautionary advice rather than a legal limit, set while longer-term safety research continues. At Evopure we think it is a very cautious figure, and many adults use more. If you go above it, increase slowly, and check with your GP or pharmacist first if you take any medication.

Getting a cholesterol test in the UK

High cholesterol usually has no symptoms, so a blood test is the only way to know. The NHS suggests asking your GP for one if you’ve never had a test and you’re over 40, overweight, or have high cholesterol or heart problems in the family. If you’re 40 to 74 and don’t already have certain long-term conditions, you should be invited to a free NHS Health Check every 5 years, which includes a cholesterol test.

It’s a blood sample from your arm or a finger-prick, and most people don’t need to fast. Don’t put it off because you’re stressed: the short-term effect on the result is small.

iThese are general guides from the NHS and BHF. Your own target depends on things like your age and health, so ask your GP what your numbers mean for you.

See also can statins make you tired?

Checking your heart health? See normal blood pressure and free checks.

See also does CoQ10 help statin side effects? The mixed evidence, and why you should keep taking your statin.

See also does high cholesterol make you tired?