Does intensive systolic blood pressure lowering reduce cardiovascular outcomes in elderly hypertensive patients regardless of baseline diastolic blood pressure?
Intensive systolic blood pressure lowering provides cardiovascular benefits regardless of baseline diastolic blood pressure in elderly hypertensive patients.
BACKGROUND: The STEP (Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients) trial demonstrated that intensive systolic blood pressure (SBP) lowering has cardiovascular benefits. However, the influence of baseline diastolic blood pressure (DBP) on the effects of intensive blood pressure lowering on cardiovascular outcomes has not been fully elucidated. METHODS: We performed a post hoc analysis of the STEP trial. Participants were randomly allocated to intensive (110 to 0.05). CONCLUSIONS: The beneficial effects of intensive SBP lowering on cardiovascular outcomes were unaffected by baseline DBP. Lower DBP should not be an obstacle to intensive SBP control. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03015311.
Yang et al. (Tue,) studied this question.