Response by Beddhu et al to Letters Regarding Article, “Influence of Baseline Diastolic Blood Pressure on Effects of Intensive Compared With Standard Blood Pressure Control”

We very much appreciate the thoughtful comments by Stavropoulos et al on our article on baseline diastolic blood pressure (DBP) and cardiovascular outcomes in SPRINT (Systolic Blood Pressure Intervention Trial).1 They wondered whether participants with baseline DBP >70 mm Hg with reductions to 70 mm Hg (71±2 mm Hg).1 As shown in Figure 1, the achieved DBP in the intensive systolic blood pressure (SBP) group was lower than that of the standard SBP group (65.2±6.6 versus 71.6±6.8 mm Hg), and as shown in Figures 2 and 3, there was no evidence that the intensive SBP group had worse cardiovascular outcomes, irrespective of the baseline DBP.1 Achieved DBP is a reflection of a multitude of factors, including the underlying arterial stiffness (patients with stiffer arteries …