High cholesterol High blood pressure (hypertension)

High cholesterol

Everyone who has had a transplant should be concerned about preventing and treating high cholesterol.

If you’ve had an organ transplant, you should be aware that a leading cause of death among patients with a working transplant is heart and blood vessel disease.

In addition, some of the medicines you take to help prevent rejection of your transplanted organ may increase your risk. Here, you can learn about risk factors and ways you can help keep your cholesterol under control.

If your levels of cholesterol get too high, it can build up inside your blood vessels and slow or block the flow of blood

Cholesterol does not simply mean fat

High cholesterol can cause blood vessels, including the ones attached to your transplanted organ, to become clogged, which slows your blood flow. This can affect the success of your transplant and may lead to coronary artery disease in the small blood vessels in and around your heart. This can also happen in other vessels around your body, including your brain, kidneys, and blood vessels in your legs.

Some foods that are high in fat can be low in cholesterol, and vice versa. Cholesterol is a soft, waxy substance present in all parts of the body, including your nerves, skin, muscles, liver, intestines, and heart. It’s transported in the blood and used to make hormones, bile acid (which helps break down food in the stomach), and vitamin D.

It is important that transplant patients watch their cholesterol levels closely with their transplant team

There are two types of cholesterol

As a transplant patient, you are more likely to have high blood pressure and diabetes. While your medicines are very important for keeping you healthy, certain medicines may increase your risk for high cholesterol, high blood pressure, and diabetes.

LDL (low-density lipoprotein) is considered to be bad cholesterol, while HDL (high-density lipoprotein) cholesterol is considered good for you. LDL attaches to the blood vessels, slowing or blocking the passage of blood. HDL removes excess cholesterol from blood vessels and takes it back to the liver to be broken down and eliminated from the body.

Your blood cholesterol level may be influenced by many factors. These include:

  • What you eat. Foods high in saturated fat, cholesterol, and calories lead to weight gain
  • Your weight. Being overweight or obese can make your LDL go up and your HDL go down
  • Physical activity. Increased activity lowers LDL and raises HDL
  • Anti-rejection medicines, immunosuppressants, and steroids may affect cholesterol levels in a number of ways

Managing cholesterol with medicines

There are several medicines available to help treat high cholesterol. Consider talking to your doctor or transplant team about whether you need to manage your cholesterol levels, and the treatments available that would be suitable for you.

The American Heart Association recommends the following cholesterol levels:

Total cholesterol: less than 200 mg/dL

LDL (bad) cholesterol:
Less than 100 mg/dL
HDL (good) cholesterol:
  • More than 40 mg/dL for men
  • More than 50 mg/dL for women

According to the Mayo Clinic, high cholesterol is a risk factor for developing heart and blood vessel disease. Some other common risk factors are listed below.

Risk factors you can’t change

  • Age
    • Above age 55
  • Gender
    • Men are at greater risk than pre-menopausal women
  • Medical history
    • A family history of early cardiovascular disease
    • A history of stroke
    • Diabetes
    • Pre-existing medical conditions

Things you may try to change

Talk to your doctor before making any changes to your lifestyle

It is a good idea to stop smoking cigarettes and to avoid all sources of second-hand smoke

Try to either stop drinking alcohol, or to drink less if you drink more than 2 alcoholic drinks per day

Consider losing weight if you are overweight

Try to exercise more if you can—a good starting point is to spend less time sitting or lying down

Aim to mainly eat good types and small portions of fats

Try to eat more fiber

This information is intended for educational purposes only. It is not intended as a substitute for speaking with your transplant team.

Leading cause of death according to Lentine KL, et al. Circulation. 2012; 31: 126(5): 617-663. Accessed October 14, 2014.
Increased likelihood of high blood pressure and diabetes according to the United Network for Organ Sharing,
www.transplantliving.org/after-the-transplant/staying-healthy/health-concerns/, accessed October 14, 2014.
Recommended cholesterol levels according to the American Heart Association, www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300301.pdf, accessed October 14, 2014.
Risk factors for heart and blood vessel disease according to the Mayo Clinic, www.mayoclinic.org/diseases-conditions/heart-disease/basics/risk-factors/con-20034056, accessed October 14, 2014.

High blood pressure (hypertension)

High blood pressure results when the force of the blood against the artery walls is too great. It occurs when blood vessels become narrow or stiff, forcing the heart to pump harder to push blood through the body. High blood pressure is common in transplant patients. The causes of hypertension may vary among kidney, heart, and liver transplant patients.

Below are some of the things that you should be aware of. There may be other things associated with high blood pressure that are not listed here, and if you have any questions or concerns about high blood pressure, talk to your doctor.

Managing high blood pressure

Your transplant team may tell you what your blood pressure should be and how often you should monitor it. It’s a good idea to check your blood pressure every day so that you can monitor any changes.

According to the American Heart Association, for most people, a good target blood pressure is less than 120 over less than 80. This means a systolic pressure (the pressure in the arteries when the heart beats) of less than 120, and a diastolic pressure (the pressure in the arteries between heartbeats, when it is resting and refilling with blood) of less than 80.

There are many medicines available to treat high blood pressure. Because they work in different ways, your transplant team may prescribe one or more.

You may want to ask your transplant team what else you can do to help manage your blood pressure. Keeping your blood pressure under control can help keep you and your transplanted organ healthy.

According to the Mayo Clinic, high blood pressure is a risk factor for developing heart and blood vessel disease. Some other common risk factors are listed below.

Risk factors you can’t change

  • Age
    • Above age 55
  • Gender
    • Men are at greater risk than pre-menopausal women
  • Medical history
    • A family history of early cardiovascular disease
    • A history of stroke
    • Diabetes
    • Pre-existing medical conditions

Things you may try to change

Talk to your doctor before making any changes to your lifestyle

It is a good idea to stop smoking cigarettes and to avoid all sources of second-hand smoke

Try to either stop drinking alcohol, or to drink less if you drink more than 2 alcoholic drinks per day

Consider losing weight if you are overweight

Try to exercise more if you can—a good starting point is to spend less time sitting or lying down

Aim to mainly eat good types and small portions of fats

Try to eat more fiber

This information is intended for educational purposes only. It is not intended as a substitute for speaking with your transplant team.

Leading cause of death according to Lentine KL, et al. Circulation. 2012; 31: 126(5): 617-663. Accessed October 14, 2014.
Increased likelihood of high blood pressure and diabetes according to the United Network for Organ Sharing,
www.transplantliving.org/after-the-transplant/staying-healthy/health-concerns/, accessed October 14, 2014.
Recommended cholesterol levels according to the American Heart Association, www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300301.pdf, accessed October 14, 2014.
Risk factors for heart and blood vessel disease according to the Mayo Clinic, www.mayoclinic.org/diseases-conditions/heart-disease/basics/risk-factors/con-20034056, accessed October 14, 2014.