ObjectiveTo determine the efficacy of pravastatin in the treatment of primary hypercholesterolaemia in patients being treated with captopril for hypertension.DesignA double‐blind parallel group study comparing 12 weeks of pravastatin therapy (20‐40 mg/day) with placebo.Participants25 patients (age, 37‐73 years) with mild‐to‐moderate hypertension and hypercholesterol‐aemia (total cholesterol level, 5.5‐8.8 mmol/L).ResultsPravastatin reduced total cholesterol levels by 22% (from 7.1± 0.29 [SEM] to 5.5± 0.25mmol/L;P<0.001) and low‐density‐lipopro‐tein cholesterol levels by 32% (from 5.0 ±0.32 to 3.4 ± 0.28 mmol/L;P<0.001) in four weeks and these levels were maintained for the 12 weeks of therapy. Pre‐pravastatin values returned three weeks after stopping therapy. Levels of total cholesterol, cholesterol fractions and triglycerides remained constant or deteriorated in the placebo group. Pravastatin therapy was well tolerated. An integrated coronary risk score showed a 40% reduction in risk.ConclusionThis study indicates that pravastatin (combined with captopril) is an effective cholesterol‐lowering drug, but that treatment needs to be maintained.