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It has been suggested that fibrates, lipid-lowering agents with a peroxisome proliferator-activated receptor-a agonistic property, lower blood pressure (BP) in some experimental models of hypertension. However, the effect of fibrates on BP in humans has been inconsistent, and there are few studies using home or ambulatory BP monitoring. We investigated the effects of bezafibrate on office, home and ambulatory BP in hypertensive patients with dyslipidemia. Thirty-two essential hypertensive patients with dyslipidemia (6 men and 26 women, mean age 65±8 years old) were assigned to a control period and a bezafibrate period (200mg twice daily) for 8 weeks each in a randomized crossover manner. Bezafibrate significantly reduced serum triglyceride, total and lowdensity lipoprotein-cholesterol, blood glucose, plasma insulin, the homeostasis model assessment ratio and increased high-density lipoprotein-cholesterol. Compared with the control period, changes in office, home and 24-h BP with bezafibrate were -0.7±2.1/ -1.6±1.2mmHg, +0.9±1.0/ -0.5±0.6 and +0.8±1.4/ -0.6±0.9mmHg, respectively. None of these differences in BP was significant. In conclusion, bezafibrate improved lipid metabolism and insulin sensitivity but did not affect office, home or ambulatory BP in hypertensive patients with dyslipidemia. Fibrates do not appear to lower BP in patients with essential hypertension.