The study examined the relationship between cholesterol levels and 24-hour ambulatory blood pressure in postmenopausal women with osteoporosis, the average age of the participants was 73 years. A negative correlation was found between total cholesterol (TC) and intact parathyroid hormone (iPTH) and also between HDL-cholesterol and β-crosslaps. At a TC level ≥ 5.5 mmol/L, TC was significantly and positively associated with increased 24-hour mean systolic blood pressure (SBP). Similarly, LDL-cholesterol (LDL-C) ≥ 3.9 mmol/l was positively correlated with several blood pressure parameters, including systolic and diastolic pressure. Conversely, low HDL-cholesterol (< 1 mmol/l) was negatively correlated with 24-hour mean systolic pressure. Below these lipid thresholds, no significant associations with blood pressure were observed. Thus, the results show a threshold effect of cholesterol on blood pressure in postmenopausal osteoporotic patients, where increased TC and LDL-C above certain values and low HDL-C are associated with higher blood pressure.