Does lowering diastolic BP to less than 90 mm Hg decrease cardiovascular risk?
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Although lowering diastolic blood pressure (DBP) is associated with reduced cardiovascular events, systolic blood pressure (SBP) is a more robust predictor of cardiovascular risk than DBP and should now be used to diagnose, stage, and treat hypertension. Lowering diastolic blood pressure (DBP) to <90 mm Hg in hypertensive individuals of all ages decreases the risk of cardiovascular events including myocardial infarction (MI), heart failure, and sudden death (strength of recommendation [SOR]: A, based on systematic review of randomized controlled trials). However, there is no consensus regarding how far to lower DBP. A “J-shaped” increase in cardiovascular risks with DBP <85 mm Hg may apply under certain conditions.
Clinical Inquiries, 2004 (MU)