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Current guidelines recommend a BP target <140/90 mmHg irrespective of cardiovascular (CV) risk level. The SPRINT showed significant benefit of treating SBP to <120 mmHg. Concerns exist regarding the potential increased CV risk from intensive DBP lowering - the diastolic J-curve. We analysed the relationship of longitudinal on-treatment SBP and DBP on CV events.

Methods: Longitudinal BPs were obtained from clinic records for hypertensive patients attending the Glasgow BP Clinic. AUC BP for the first year (Y1) and 2-5years (Y2-5) were calculated for patients who had >2 BP measurements during these periods. Survival analyses were performed using Cox proportional hazard model adjusted for age, sex, cholesterol, smoking status, BP (time-dependent) and Charlson comorbidity index (time-dependent).

Results: There were 4813 eligible patients (mean age 54±14 years; female 52%). The average …