Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp n the past, the goal of treating patients with hypertension or hypercholesterolemia was merely to control numerical factors such as blood pressure (BP) or serum cholesterol level alone; nowadays, it has changed. The updated guidelines target reductions in overall cardiovascular risk. 1,2 Hypercholesterolemia and hypertension are both associated with endothelial dysfunction and insulin resistance (IR) and their coexistence is a vicious cycle associated with an increased incidence of cardiovascular events. Moreover, both risk factors are frequently prevail together. 3,4 Indeed, more than 60% of hypertensive patients were consistently hypercholesterolemic in the United States National Health and Nutrition Examination Surveys 1988Surveys -2010 More importantly, the prevalence of dyslipidemia increased parallel to BP. In the prehypertensive range, prevalence was similar to that of the general population, approximately 26%; however, this prevalence doubles in the hypertensive population, reaching nearly 60%. 6 Although it is not possible to provide a definite pathogenesis of hypertensionhypercholesterolemia/dyslipidemia clustering, it is gaining consensus that IR and endothelial dysfunction might play major roles. 7, 8 From 1988-1994 to 2005-2010, control of concomitant hypertension and the low-density lipoprotein-cholesterol (LDL-C) level rose from 5.0% to 30.7%. By multivariable logistic regression, factors associated with concomitant hypertension, LDL-C, and non-high-density lipoprotein-cholesterol control were statin therapy (10.7) and antihypertensive (3.32) medications, and ≥2 healthcare visits/year (1.90), whereas age (0.77/10-year increase), black race (0.59), Hispanic ethnicity (0.62), cardiovascular disease (CVD) (0.44), and diabetes mel-