A previously published study reported on an open-label, multicenter study of the efficacy and tolerability of lovastatin in the management of nonfamilial primary hypercholesterolemia. In the present report the results from the 213 hypercholesterolemic patients with systemic hypertension are presented. At baseline mean +/- SD of total serum cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, and the ratio of total serum cholesterol to HDL cholesterol were 268 +/- 24, 189 +/- 22 and 43 +/- 10 mg/dl and 6.6 +/- 1.6, respectively. Of the 213 hypertensive patients only 24 were not receiving antihypertensive or related cardiac medication. Baseline mean systolic and diastolic blood pressures were 140 +/- 20 and 84 +/- 9 mm Hg, respectively. Within 1 month of lovastatin therapy the observed significant reductions in total serum cholesterol, low-density lipoprotein cholesterol and the ratio of total to HDL cholesterol were 19, 27 and 24%, respectively. HDL cholesterol was increased by 6%. Diastolic blood pressure did not change significantly during this 1-month period. The 1-month lipid results were maintained over the full 6 months of the study. The dosage of lovastatin was 20 mg/day for the first month of therapy and could subsequently be adjusted to response, up to a maximum of 80 mg/day. Again, without changes in diastolic blood pressure, lovastatin was generally effective in improving the serum lipids of hypercholesterolemic hypertensive patients regardless of the type of antihypertensive medications received (including diuretics and beta blockers). Lovastatin was generally well tolerated.