Aim To determine whether obesity and glucolipide metabolism could influence the antihypertensive effect of selective β1 adrenergic receptor blocker, metoprolol. Methods 300 Patients with 1 or 2 grade essential hypertension were enrolled and treated with metoprolol for 8 weeks, with analysis of the relationship between total effective rate rate and obesity or centre obesity, diabetes mellitus and hyperlipoidemia. Results Patients with normal body mass index had greater effective rate of metoprolol treatment than patients who were overweight or obesity, patients without centre obesity had greater effective rate than the ones with centre obesity, and sex difference existed in the influence of diabetes mellitus and hyperlipoidemia to metoprolol treatment (p<0.05). Body mass index were the most influential factors to effect of metoprolol through Logistic analysis. Conclusion Obesity or centre obesity, diabetes mellitus and hyperlipoidemia were related with antihypertensive treatment of metoprolol, specifically in men.