OBJECTIVES: Therapeutic compliance (TC) is related to risk control in the hypertensive patient. Nevertheless there is no much information on how the improvement of TC impacts on cardiovascular risk factors (CVRF), particularly on lipid parameters, in the Spanish hypertensive patients. To analyze the relationship among TC improvement (estimated by the relationship between amount of drug dispensed and amount of drug prescribed), and the variations in LDL-cholesterol (LDLc) and HDL-cholesterol (HDL-c) levels. METHODS: Hypertensive patients from five Spanish primary care centres, who had registered values of LDLc and HDLc, between 2004 and 2005, were retrospectively studied. Changes in TC, LDLc and HDLc were calculated between mentioned years. Correlation between: a) changes in TC and HDL, and b) changes in TC and HDL, were calculated using the Spearman's Rho test. RESULTS: Of the 6,960 hypertensive patients, 5,094 had registered HDL-c levels in 2004 and 2005. An increase in TC of 3.8% (DE:17.7%) was demonstrated. An inverse and statistically significant relationship between LDLc and TC (p=0.003) was demonstrated. No relationship was found between TC improvement and HDLc (p=0.9456) CONCLUSIONS: In the Spanish hypertensive population, CT improvements are associated to a decrease in LDLc levels, with no impact on HDL. Available treatments are not effective enough to improve HDLc levels in the Spanish hypertensive patient.