Can High Blood Pressure Medications Affect Cholesterol?

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.

Doctor checks man's blood pressure.
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Blood Pressure Drugs With Neutral Effect

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) which include drugs such as telmisartan (Micardis), valsartan (Diovan), losartan (Cozaar), etc.
  • Calcium channel blockers such as amlodipine (Norvasc), felodipine (Plendil), verapamil (Verelan)

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, metaxalone)
  • Certain beta blockers, like bisoprolol (Zebeta), nadolol (Corgard), metoprolol (Toprol, Lopressor), propranolol (Inderal), atenolol (Tenormin), nebivolol (Bystolic)

These medications may increase your total cholesterol levels, but because these changes are usually transient and small, this should not be a reason to discontinue taking your blood pressure medications.

Cholesterol-Lowering 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.

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By Jennifer Moll, PharmD
Jennifer Moll, MS, PharmD, is a pharmacist actively involved in educating patients about the importance of heart disease prevention.