{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T01:50:09Z","timestamp":1771984209749,"version":"3.50.1"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,3,19]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Among individuals with hypertension and low diastolic blood pressure (DBP), the optimal BP target remains controversial due to concerns that BP lowering may reduce coronary perfusion. We determined the impact of intensive BP control among individuals with elevated systolic BP who have low DBP and elevated hs\u2010cTnT (high\u2010sensitivity cardiac troponin T) levels.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 8828 participants in SPRINT (Systolic Blood Pressure Intervention Trial) were stratified by baseline DBP. Those with low DBP (&lt;70\u2009mm\u2009Hg) were further stratified by elevated hs\u2010cTnT (\u226514\u2009ng\/L) at baseline. The effects of intensive versus standard BP lowering on a cardiovascular disease composite end point, all\u2010cause death, and 1\u2010year change in hs\u2010cTnT were determined. The combination of low DBP\/high hs\u2010cTnT was independently associated with a higher risk for cardiovascular disease and all\u2010cause death, as well as greater 1\u2010year increases in hs\u2010cTnT, compared with DBP \u226570\u2009mm\u2009Hg. However, randomization to intensive versus standard BP lowering led to similar reductions in cardiovascular disease risk among individuals with low DBP\/high hs\u2010cTnT (hazard ratio [HR], 0.82 [95% CI, 0.57\u20131.19]), low DBP\/low hs\u2010cTnT (HR, 0.48 [95% CI, 0.29\u20130.79]), and DBP \u226570\u2009mm\u2009Hg (HR, 0.73 [95% CI, 0.60\u20130.89];\n              <jats:italic>P<\/jats:italic>\n              for interaction=0.20). Intensive BP lowering also led to a reduction in all\u2010cause death that was similar across groups (\n              <jats:italic>P<\/jats:italic>\n              for interaction=0.57).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In this nonprespecified subgroup analysis of SPRINT, individuals with low DBP and elevated hs\u2010cTnT, low DBP and nonelevated hs\u2010cTnT, and DBP \u226570\u2009mm\u2009Hg derived similar cardiovascular disease and mortality benefits from intensive BP lowering. These findings warrant confirmation in other studies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.032493","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T11:07:59Z","timestamp":1710760079000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Intensive Blood Pressure Lowering in Individuals With Low Diastolic Blood Pressure and Elevated Troponin Levels in SPRINT"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4060-6574","authenticated-orcid":false,"given":"Cady","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University of California Davis Sacramento CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5004-8155","authenticated-orcid":false,"given":"Jarett D.","family":"Berry","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Texas at Tyler Health Science Center Tyler TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1579-5390","authenticated-orcid":false,"given":"Rebecca","family":"Scherzer","sequence":"additional","affiliation":[{"name":"Kidney Health Research Collaborative, Department of Medicine San Francisco Veterans Affairs Health Care System and University of California San Francisco San Francisco CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2211-7261","authenticated-orcid":false,"given":"James A.","family":"de Lemos","sequence":"additional","affiliation":[{"name":"Divison of Cardiology, Department of Internal Medicine University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4237-0267","authenticated-orcid":false,"given":"Vijay","family":"Nambi","sequence":"additional","affiliation":[{"name":"Michael E DeBakey Veterans Affairs Hospital and Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6432-1730","authenticated-orcid":false,"given":"Christie M.","family":"Ballantyne","sequence":"additional","affiliation":[{"name":"Department of Medicine and Center for Cardiometabolic Disease Prevention Baylor College of Medicine Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5575-529X","authenticated-orcid":false,"given":"Richard L.","family":"Kravitz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of California Davis Sacramento CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1629-9468","authenticated-orcid":false,"given":"Anthony A.","family":"Killeen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology University of Minnesota Minneapolis MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8084-9869","authenticated-orcid":false,"given":"Joachim H.","family":"Ix","sequence":"additional","affiliation":[{"name":"Division of Nephrology\u2010Hypertension University of California San Diego La Jolla CA USA"},{"name":"Nephrology Section Veterans Affairs San Diego Healthcare System San Diego CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9559-204X","authenticated-orcid":false,"given":"Michael G.","family":"Shlipak","sequence":"additional","affiliation":[{"name":"Kidney Health Research Collaborative, Department of 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