Association Between Baseline Diastolic Blood Pressure and the Efficacy of Intensive vs Standard Blood Pressure–Lowering Therapy

Key Points Question Is there an interaction between baseline diastolic blood pressure and intensification of blood pressure–lowering therapy for survival and cardiovascular outcomes? Findings In this cohort study of 14 094 patients from 2 large randomized clinical trials, baseline DBP of 80 and 90 mm Hg were associated with significant reductions in the risk of a composite cardiovascular end point that included cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. The same was not true for the outcome of all-cause death. Meaning The findings of this study suggest that further work is needed to determine whether blood-pressure lowering therapy should be intensified in patients whose diastolic blood pressure is low.