Can lisinopril raise your cholesterol? The Definitive Answer

October 10, 2025 •

3 min read

According to several clinical studies, lisinopril, a common ACE inhibitor, is typically considered lipid-neutral and does not negatively affect cholesterol levels in most patients. The question, "Can lisinopril raise your cholesterol?" is a common concern for those managing both high blood pressure and lipid health. Rest assured, research indicates this medication does not typically elevate your cholesterol.

Quick Summary

Lisinopril is an ACE inhibitor used to treat high blood pressure, and it is generally considered to have a neutral or even beneficial effect on cholesterol levels, unlike some other antihypertensive drugs. The medication does not typically raise total cholesterol, LDL, or triglycerides and can be safely used alongside cholesterol-lowering therapies.

Key Points

Lisinopril is lipid-neutral: Multiple studies have shown that lisinopril does not negatively affect cholesterol levels in most patients.
No increase in LDL or Total Cholesterol: Lisinopril therapy is not associated with a rise in total cholesterol or LDL ("bad") cholesterol.
Slightly favorable effects possible: Some research has noted a minor, potentially beneficial effect on lipid profiles, including a slight increase in HDL ("good") cholesterol.
Differs from other blood pressure drugs: Certain older beta-blockers and high-dose diuretics can temporarily affect cholesterol, unlike lisinopril.
Can be combined with statins: For patients with high cholesterol, lisinopril can be safely taken alongside a statin, a medication specifically designed to lower cholesterol.
Monitor your overall lipid profile: While lisinopril is safe, other factors like diet and exercise significantly impact cholesterol, requiring regular monitoring by your doctor.

Understanding Lisinopril and Its Impact on Your Body

Lisinopril is an ACE inhibitor prescribed for high blood pressure, heart failure, and improving outcomes after a heart attack. It works by blocking angiotensin II, a hormone that narrows blood vessels and increases blood pressure. This blockage allows blood vessels to relax, lowering blood pressure and easing the heart's workload.

The Direct Effect of Lisinopril on Cholesterol

Research spanning decades indicates that lisinopril generally does not negatively affect cholesterol and is considered lipid-neutral. Some studies even suggest potential modest benefits, particularly in certain patient groups. For example, studies in patients with chronic kidney disease showed dose-dependent reductions in total cholesterol and LDL with increasing lisinopril doses. However, the most consistent finding in hypertensive patients is that lisinopril does not significantly change total or LDL cholesterol levels long-term.

Contrasting Lisinopril with Other Antihypertensive Medications

The impact of blood pressure medications on cholesterol varies. This is important for doctors considering prescriptions for patients with high cholesterol.

Some Older Beta-Blockers: May slightly increase triglycerides and decrease HDL cholesterol. Newer versions are less likely to have this effect.
High-Dose Diuretics: Older thiazide diuretics at high doses can temporarily increase triglycerides and LDL cholesterol. Low doses usually do not affect cholesterol.
ACE Inhibitors (like Lisinopril) and ARBs: Known for their neutral effect on cholesterol, making them suitable for patients with both high blood pressure and high cholesterol.

Comparison of Common Antihypertensive Drug Effects on Cholesterol


Drug Class	Example Medications	Typical Effect on Total Cholesterol	Typical Effect on LDL	Typical Effect on HDL	Typical Effect on Triglycerides
ACE Inhibitors	Lisinopril, Enalapril	Neutral to slightly favorable	Neutral to slightly favorable	Neutral to slightly favorable	Neutral
ARBs	Losartan, Valsartan	Neutral	Neutral	Neutral	Neutral
Older Beta-Blockers	Metoprolol, Atenolol	Neutral	Slight increase	Slight decrease	Slight increase
Thiazide Diuretics	Hydrochlorothiazide	Neutral at low dose; mild increase at high dose	Neutral at low dose; mild increase at high dose	Mild decrease at high dose	Mild increase at high dose
Calcium Channel Blockers	Amlodipine	Neutral	Neutral	Neutral	Neutral

Factors That Truly Influence Your Cholesterol

Beyond medication, numerous factors affect cholesterol levels:

Diet: High intake of saturated and trans fats increases LDL cholesterol.
Lack of Exercise: Physical activity can boost HDL and lower LDL and triglycerides.
Genetics: Family history significantly influences cholesterol metabolism.
Weight: Excess weight can raise cholesterol and heart disease risk.
Age and Gender: Cholesterol levels generally increase with age, with differences between sexes.
Other Medications: Certain other drugs, including some diuretics and beta-blockers, can mildly impact cholesterol.

What to Do If You're on Lisinopril and Have High Cholesterol

Doctors may prescribe a statin alongside lisinopril for patients with both high blood pressure and high cholesterol. This combination is safe and effective, with lisinopril managing blood pressure and the statin targeting cholesterol. Regular monitoring of your lipid profile by your doctor is crucial to ensure your treatment plan is working.

Conclusion

Contrary to the misconception, lisinopril does not raise cholesterol. Research consistently shows it is lipid-neutral or may even have a minor positive effect on cholesterol levels. While lisinopril is safe regarding cholesterol, many other factors influence lipid levels. Discuss your cholesterol and heart health with your healthcare provider to determine the best treatment and lifestyle strategies. Following medical advice and maintaining a healthy lifestyle are key to managing both blood pressure and cholesterol.

For more information on cholesterol management, consider visiting the American Heart Association website.

Frequently Asked Questions

No, lisinopril does not cause high cholesterol. Research consistently shows that lisinopril has a neutral or sometimes even a slightly positive effect on a person's lipid profile.

Yes, lisinopril can be safely and effectively used with a statin. Lisinopril is for blood pressure, and a statin is for cholesterol, with each drug working on different pathways to improve cardiovascular health.

Yes, some older medications, such as certain beta-blockers and high-dose thiazide diuretics, have been known to cause minor, temporary elevations in triglycerides and LDL cholesterol.

In general, ACE inhibitors like lisinopril are considered 'lipid-neutral.' This means they do not have a significant adverse or beneficial effect on the body's lipid profile.

If your cholesterol increased, it is likely due to other factors and not the lisinopril. Potential causes include dietary changes, lack of exercise, weight gain, or underlying health conditions. You should discuss this with your doctor to identify the real cause.

Lisinopril is a safe and effective option for patients with high cholesterol because it does not negatively impact lipid levels. Your doctor will determine the best medication based on your full health profile, including both blood pressure and cholesterol.

Yes. By effectively lowering your blood pressure, lisinopril helps reduce the strain on your heart and blood vessels. This can help lower your overall risk of cardiovascular events, regardless of its neutral effect on cholesterol.