Letter by Koh Regarding Article, “J Curve in Patients Randomly Assigned to Different Systolic Blood Pressure Targets: An Experimental Approach to an Observational Paradigm”
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To the Editor:
Kalkman and colleagues1 presented an interesting and timely post hoc analysis of the pooled database of the SPRINT (Systolic Blood Pressure Intervention Trial) and ACCORD (Action to Control Cardiovascular Risk in Diabetes) trials, which randomly allocated patients at high vascular risk to an intensive (systolic blood pressure [SBP] <120 mm Hg) or conventional (SBP <140 mm Hg) target. It is interesting to note that for both blood pressure (BP) targets, an identical J-curve shape was present, with a nadir for cardiovascular events and all-cause mortality just below the SBP target. Patients in the lowest SBP stratum were older, had a higher body mass index, …