Trial reportHeart (British Cardiac Society)2026
Efficacy and safety of intensive antihypertensive strategy in patients with low diastolic blood pressure: a secondary analysis of a cluster randomised trial.
Trial report in Heart (British Cardiac Society), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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14 authors.
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Abstract
backgroundIntensive blood pressure (BP) control <130/80 mm Hg could bring additional benefits for cardiovascular disease (CVD). However, it is unclear whether intensive BP control remains effective and safe in the general hypertensive population with low diastolic BP (DBP) since a J-shaped relationship between DBP and CVD was observed.
methodsThis is a post hoc analysis of the China Rural Hypertension Control Project. Mixed-effect Cox proportional regression and generalised estimating equation models were used to determine HRs of outcomes by intensive BP control, stratified by baseline DBP quartiles. The interaction between intervention and DBP levels was assessed.
resultsA total of 33 288 participants were divided into four categories according to baseline DBP quartiles (Q1-Q4): DBP ≤80.7 mm Hg, 80.7-87.3 mm Hg, 87.3-94.3 mm Hg and >94.3 mm Hg, respectively. Compared with usual care, the intervention group reduced cardiovascular outcomes across DBP quartiles with adjusted HRs as follows: Q1: 0.69 (95% CI 0.58 to 0.83, p<0.001), Q2: 0.60 (95% CI 0.50 to 0.71, p
conclusionsThe intensive BP intervention led by non-physician providers is both effective and safe in reducing CVD and mortality across all baseline DBP groups.
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