How does stress affect cholesterol levels?
Stress has various effects on the body. One of these is that it may increase cholesterol levels. This can happen indirectly through adopting unhealthful habits as a way of coping. However, there may also be a direct biological link.
When the body faces stress, certain physiological reactions take place, including changes in levels of hormones and components in the blood. Both of these events might lead to higher cholesterol.
Scientists do not know precisely what links stress and cholesterol, but there are several theories. This article looks at why this might happen and how to reduce the risk of stress-related cholesterol problems.
How the body reacts to stress
When a person faces stress, their body automatically prepares their muscles, heart, and other organs and functions for a high-energy, fight-or-flight response.
Whether the person decides to run away or to stay and face the threat, their body will react in certain ways.
The body will release the hormones epinephrine (adrenaline), norepinephrine, and cortisol.
Epinephrine triggers the heart to work harder, leading to a rise in:
- heart rate
- blood pressure
Cortisol causes the body to releases glucose and fatty acids to the muscles and blood for use as energy. You can learn more about the link between stress and cortisol and how to reduce stress-related cortisol levels here.
These hormone levels will usually remain high until the person resolves the stressful situation. However, sometimes the stress levels do not drop or take time to return to their lower levels.
These factors may lead to higher cholesterol levels both in the long-term and the short-term.
Stress and cholesterol
A 2013 study that looked at data for 91,593 people found a positive correlation between those who experienced job stress and unhealthful cholesterol levels.
Another study, published in 2017, also found that psychological stress led to higher levels of triglycerides and low-density lipoproteins (LDL), the “bad” cholesterol, and decreasing levels of high-density lipoproteins (HDL), or “good” cholesterol.
Scientists have suggested some ways in which stress reactions can lead to higher cholesterol.
When a person faces stress, they may experience hemoconcentration. This causes the blood to lose fluid. The components of the blood, including cholesterol, become more concentrated. This could be one way in which stress leads to higher cholesterol levels in the short term.
One possible reason for this may be that as blood pressure rises, fluid moves from the blood vessels to the interstitial spaces around them.
People who experience long-term stress may have consistently high levels of cholesterol in their body. This could be due to the hormone cortisol.
High cortisol levels can:
- increase obesity around the stomach because of more fat deposits
- affect fat in other parts of the body
- increase appetite
At times of stress, people often eat less healthfully, turning to sugary “comfort” foods, as these appear to reduce the feelings of stress. Overconsumption of high-carbohydrate foods can cause weight gain and obesity. High cholesterol levels often occur with excess weight.
Scientists have also suggested in one study that because stress adversely affects the immune system, it can lead to inflammation. This may affect cholesterol levels, for example, in people with some types of liver disease.
The authors of the study propose that a long-term inflammatory effect may increase lipid levels and obesity in people with severe anxiety disorders and depression. Smoking may also be a factor.
If the body releases free fatty acids and glucose for energy during a stressful time and the person does not use these for energy, this could also cause cholesterol levels to rise.
Other effects of stress on the heart
Stress can also have other effects on the body, some of which can be dangerous.
In a person with coronary heart disease (CHD), mental stress can lead to ischemic heart disease, a condition in which the heart does not receive enough blood.
According to a study published in 2013, when stress leads to a reduction in blood supply to the heart, this can increase the risk of a heart attack.
The researchers took measurements of heart ischemia from 310 people with stable CHD. When they faced mental stress, nearly 44 percent of the participants showed signs of heart ischemia.
The participants were more at risk of developing mental stress-related ischemia than exercise-related ischemia, the results showed.
The authors of the research also discussed how sex, marriage, and living arrangements could influence heart problems. They call for more research into these factors.
The cardiovascular reactivity theory
Researchers have found that some people’s cardiovascular system reacts more than others in response to stress. For example, some people’s blood pressure rises more than others at stressful times.
The cardiovascular reactivity hypothesis suggests that stress may increase the risk of heart disease in certain people. Often, a person with high cholesterol levels is already at a higher risk of experiencing a cardiovascular event, such as a heart attack. Stress could trigger such an event.
When people have high cholesterol, the walls of their arteries experience changes. Sometimes, these changes make the arteries less elastic, so the blood vessels are less able to open up in response to stress.
Indirect effects of stress on cholesterol
Scientists have a reasonable understanding of the indirect effects of stress on cholesterol. For example, they know that when a person faces stress, they may be more likely to engage in certain behaviors that can increase or decrease cholesterol levels.
Factors that may indirectly cause cholesterol to rise include:
Dietary changes: In the short term, a person experiencing stress may not want to eat. In the long-term, however, the hormonal impact of stress can increase a person’s appetite.
Alcohol and tobacco: A person experiencing stress may increase their alcohol intake, and they may smoke more, or return to smoking after quitting.
Exercise: Physical activity directly affects cholesterol levels. If a person experiencing stress reduces the amount of physical activity they do, their cholesterol levels will likely rise.
What is stress?
Stress is a broad and often vague term. Things that cause stress are called stressors, and every individual responds differently to them. What one person finds stressful, another person may see as exciting.
One definition of stress is when a person finds it difficult to cope with or manage a situation because they do not have — or believe that they do not have — the mental or physical resources to do so.
Stress can occur when a person feels under pressure or that they are not in control of their situation.
This can happen when life changes occur to an individual or someone they care about. Factors that can lead to stress include illness, a traumatic incident, moving house, changes in marital status, a loss of a loved one, and so on.
The person may feel
- anxious, worried, or depressed
- threatened or vulnerable
- anger and aggression
What is cholesterol?
Cholesterol is a fat-like, waxy-looking substance. It is essential for every cell of the body and has several functions. One of these is to make up the structure of cell walls.
There are two sources of cholesterol:
- the body produces it
- people take it in through food
The blood does not carry cholesterol around freely. Instead, it travels through the blood in substances called lipoproteins. This is why scientists use lipid levels to measure cholesterol.
Two types of lipoproteins carry cholesterol:
- LDL, or “bad” cholesterol
- HDL, or “good” cholesterol
Healthy cholesterol levels
The Centers for Disease Control and Prevention (CDC) recommend that adults visit their doctor’s office every 5 years for a blood test to check their cholesterol levels.
The CDC recommend that people keep their overall cholesterol levels low, especially the “bad” LDL cholesterol.
Desirable cholesterol levels are:
Total cholesterol under 200 milligrams per deciliter (mg/dL)
- LDL cholesterol under 100 mg/dL
- HDL cholesterol at least 60 mg/dL
However, target cholesterol levels vary for each person.
Preventing stress-related high cholesterol
Managing stress levels is an individual matter, as people react in a variety of ways to different stressors, and their past experience also affects how they respond.
Ways to manage stress might include:
- following a healthful diet that is high in fruits, vegetables, and whole foods
- getting regular exercise
- doing activities that focus on relaxation and meditation, such as yoga
- achieving a healthy work-life balance
- asking others to help with chores
- spending social time with friends and family
- making time for things you enjoy, such as a walk in the countryside
- developing good sleep habits, including not taking electronic devices to the bedroom or sleeping area
- engaging in positive self-talk
For people whose cholesterol levels pose a risk of further complications, a doctor can prescribe drug treatments, such as statins.
Anyone who is concerned that their stress is having an adverse impact on their life should see a doctor, as they may be able to recommend treatment. This could include counseling and possibly medication.