It’s possible to develop high cholesterol on its own. But often, it’s a comorbidity, meaning it can appear with other chronic conditions like diabetes and high blood pressure.

Cholesterol is a fat-like substance naturally produced by your liver. It circulates in the blood and contributes to many important functions, like making hormones and vitamin D. But high levels of lipids (fats) in the bloodstream may be harmful.

Over time, high cholesterol can lead to heart disease, which increases your risk of heart attack and stroke.

Having comorbidities increases your risk of complications. So, it’s important to manage these conditions and consider how they might interact.

Comorbidity is when you have more than one condition at the same time. These conditions are usually chronic, meaning that they need long-term treatment or management.

Comorbid conditions are also called:

  • coexisting conditions
  • co-occurring conditions
  • multimorbidity
  • multiple chronic conditions

A comorbidity is different from a complication. A complication is a medical problem that develops during a disease or treatment. Complications can also occur after a procedure.

Comorbidities are significant because they increase your risk of complications. For example, the conditions might cause or worsen each other.

Your doctor will also need to consider all your conditions when treating each one.

Keep reading to learn more about common comorbidities of high cholesterol.

High cholesterol commonly appears with obesity, a disease involving excess body fat, for several reasons.

First, the excess fat in obesity causes your liver to overproduce very-low-density lipoprotein (VLDL) cholesterol, or “bad” cholesterol.

Excess body fat also causes inflammation. This triggers VLDL production and decreases high-density lipoprotein (HDL) cholesterol, or “good” cholesterol.

High cholesterol is also a comorbidity of diabetes, a disease that causes chronically high blood sugar levels due to insulin deficiency and resistance.

Insulin is a hormone that helps your cells take up glucose, or sugar, for energy. This helps regulate blood glucose levels. With insulin deficiency, your body doesn’t produce enough insulin, so your cells are unable to properly take up glucose.

Insulin dysfunction can lead to higher LDL levels, lower HDL levels, and increased levels of triglycerides, another type of fat in the blood.

High cholesterol is a major risk factor for heart disease. As a result, the two conditions often appear together.

High cholesterol can lead to atherosclerosis, or the buildup of plaque in your blood vessels. Atherosclerotic plaques, or fatty deposits, are made of:

  • cholesterol
  • cellular waste products
  • fatty substances
  • fibrin (a blood-clotting protein)

Over time, atherosclerotic plaques can reduce blood flow to your heart. This increases your risk of heart disease, heart attack, and stroke.

High cholesterol and hypertension (high blood pressure) are two of the main risk factors for heart disease. They’re also comorbid conditions.

High cholesterol and hypertension share many risk factors, including:

  • a diet high in saturated fats
  • low physical activity levels
  • higher body weight
  • age

Additionally, high cholesterol can contribute to hypertension. Excess cholesterol can build up in the blood vessels, causing atherosclerosis. This makes your blood vessels narrow and rigid, reducing blood flow and increasing blood pressure.

High cholesterol is a comorbidity for obstructive sleep apnea, a sleep disorder. Sleep apnea happens when your upper airways repeatedly collapse during sleep, which interrupts breathing.

People with sleep apnea may be more likely to have high cholesterol. The condition may trigger inflammation and oxidative stress (an imbalance in the body that damages the cells), potentially contributing to increased blood cholesterol levels.

Also, like high cholesterol, sleep apnea often appears with conditions like:

  • diabetes
  • obesity
  • atherosclerosis

Atrial fibrillation (AFib) is a type of arrhythmia, or irregular heartbeat. It happens when the upper and lower chambers of the heart beat out of sync.

High cholesterol is associated with a higher risk of AFib, according to a 2019 study. More research is needed to understand the link, but it may be related to high cholesterol altering the tissue in the heart.

Also, AFib may appear with other conditions that can coexist with high cholesterol, including:

  • high blood pressure
  • heart disease
  • obesity
  • sleep apnea
  • diabetes

If you have high cholesterol, your doctor will likely recommend the following:

  • Dietary changes: This includes eating more fruits, veggies, and unsaturated fats. It also includes limiting foods high in saturated fats, salt, and sugar.
  • Regular physical activity: The Physical Activity Guidelines for Americans recommend 3 to 5 hours of moderate intensity physical activity per week for most adults.
  • Avoid or quit smoking: If you smoke, your doctor can help you quit.
  • Medications: You might need to take cholesterol-lowering medications, such as statins. It’s important to take these medications in addition to making lifestyle changes.

These lifestyle modifications can also manage other conditions that appear with high cholesterol.

Depending on these conditions, your doctor may suggest additional therapies or medications to help you stay healthy.

High cholesterol is a major risk factor for heart disease. It can develop on its own or with other conditions known as comorbidities. This can increase the risk of complications.

Comorbidities of high cholesterol include obesity, diabetes, hypertension, and heart disease. It can also coexist with sleep apnea and AFib.

In many cases, managing high cholesterol will help manage other conditions. Your doctor can provide personalized guidance depending on your specific health situation.