INVEST [10, 40] |
Observational / Post hoc analysis |
Patients age >50 years with established coronary artery disease |
Tight control (<130 mmHg) was not associated with improved cardiovascular outcomes as compared to usual control (between 130-140 mmHg); Usual control as compared to uncontrolled SBP (>140 mmHg) was associated with improved outcomes |
DBP <70-80 mmHg is associated with increased mortality in patients with SBP is between 110-120 mmHg, as compared to patients with SBP between 120-140 mmHg |
CLARIFY [41] |
Observational / Post hoc analysis |
Patients with known stable coronary artery disease |
SBP <120 mmHg or SBP >140 mmHg was associated with increased mortality and adverse cardiovascular outcomes |
DBP <70 mmHg or DBP >80 mmHg was associated with increased mortality and adverse cardiovascular outcomes |
VALUE [35,57] |
Randomized Controlled Trial |
Patient population with risk factors for cardiovascular disease and those with established coronary artery disease (~50% of cohort) |
Achieving SBP <140 mmHg was associated with significant benefits in terms of combined cardiac events, myocardial infarction, stroke, and mortality |
No differences in cardiovascular morbidity between patients with DBP <70 mmHg as compared to those with DBP >70 mmHg |
ARIC [39] |
Observational / Post hoc analysis |
Patients with risk factors of cardiovascular disease but without prior established cardiovascular disease or heart failure |
|
In patients with SBP >120 mmHg, lowering DBP below 70 mmHg and particularly below 60 mmHg, was associated with increased incidence of coronary events and mortality |