Hypertension and hyperlipidemia are interrelated and share common pathophysiologic mechanisms, such as insulin resistance and endothelial dysfunction. Accumulating evidence shows that it is important to regulate hypertension and hyperlipidemia to reduce cardiovascular risk. However, medications such as beta-blockers and thiazide diuretics, which are widely used for blood pressure regulation, are known to have several metabolic side effects. Despite deleterious effects on glucose metabolism and lipid metabolism, these medications have been proven to reduce cardiovascular risk. On the other hand, calcium channel blockers, angiotensin-converting enzyme inhibitors, and alpha-blockers have either no effect or favorable effects on the lipid profile. This review outlines the need to control hypertension, options for several antihypertensive medications, their differing effects on lipid metabolism, and the clinical implications of their effects on lipid parameters.