Can Your High Blood Pressure Medications Affect Your Lipids?

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High blood pressure and high cholesterol are the most common conditions that can lead to cardiovascular disease if ignored. The good news is that both conditions are treatable with lifestyle modifications and/or medication. 

There are many medications that can be used to help control your high blood pressure, but in some cases, these drugs may also have an effect on your cholesterol and triglyceride levels.

Some blood pressure-lowering medications may improve your lipid profile - whereas some drugs may actually  make it worse. Fortunately, even if some of these medications raise your cholesterol levels, the effect is usually only slight and temporary.

Blood Pressure Drugs that Have a Neutral Effect on Cholesterol

Studies have shown that the following blood pressure medications have little effect, if any, on your cholesterol levels, including:

  • Reserpine (Sereplan)
  • Hydralazine (Apresoline)
  • Potassium sparing diuretics, like spironolactone (Aldactone)
  • Angiotensin converting enzyme inhibitors (also known as ACE inhibitors) – such as lisinopril (Zestril), ramipril (Altace), quinapril (Accupril), etc.
  • Angiotensin II receptor blockers (also known as ARBs) – includes drugs such as telmisartan (Micardis), valsartan (Diovan), losartan (Cozaar), etc.
  • Calcium channel blockers – such as amlodipine (Norvasc), felodipine (Plendil), verapamil (Verelan)

    Blood Pressure Meds that May Negatively Impact Your Cholesterol Levels

    There are other commonly used blood pressure medications that may have a slightly negative effect on your cholesterol. These medications could increase your LDL, or “bad”, cholesterol levels, your total cholesterol levels, and triglycerides and lower your HDL cholesterol.

    These drugs include:

    • High doses of certain diuretics, like loop diuretics (furosemide, torsemide) and thiazide diuretics (hydrochlorothiazide, metazolone)
    • Certain beta blockers, like bisoprolol (Zebeta), nadolol (Corgard), metoprolol (Toprol, Lopressor), propanolol (Inderal), atenolol (Tenormin), nebivolol (Bystolic)

    Studies have shown that taking these medications may increase your total cholesterol levels by at least 5 to 10 mg/dL. Because these changes are usually transient and small, this should not be a reason to discontinue taking your blood pressure medications.

    Cholesterol-Lowering Blood Pressure Medications

    There are other blood pressure lowering medications that have also been shown to slightly lower your cholesterol levels, as well as modestly raise HDL cholesterol. These include:

    • Alpha-1 adrenergic blockers, such as prazosin (Minipress) or doxazosin (Cardura)

    Although these medications have a positive effect on your cholesterol numbers, this effect will probably not be sufficient enough to treat your high cholesterol, too.

    Your healthcare provider will select the appropriate blood pressure medication for you. If you have high cholesterol and/or triglyceride levels, your healthcare provider will monitor your lipid levels periodically and may adjust your dose - or switch you to another blood pressure medication - depending upon your response to the drug. If you are worried about your blood pressure medication interacting with your lipid levels, you should address your concerns with your healthcare provider. 


    Dipiro JT, Talbert RL. Pharmacotherapy: A Pathophysiological Approach, 9th ed 2014.

    Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (PDF), July 2004, The National Institutes of Health: The National Heart, Lung, and Blood Institute.

    Micromedex 2.0.  Truven Health Analytics, Inc. Greenwood Village, CO.  Available at:  Accessed February 10, 2016

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