Abstract 10123: Evidence Against the J-shaped Curve in Treated Hypertensive Patients With Increased Cardiovascular Risk: The VALUE Trial

Introduction: It has been postulated that low blood pressure (BP) during treatment is associated with increased risk for cardiovascular (CV) disease. Hypothesis: We tested whether low BP had unfavorable effect on CV outcomes in a high risk population of 15,244 hypertensive patients of whom 45% had a coronary heart disease (CHD) history. Methods: Patients were followed for 4.2 years (mean) in the VALUE Trial with no difference of the primary endpoint between valsartan and amlodipine arms. Cox proportional hazard models were used to evaluate relationships between average on-treatment BP and clinical outcomes, unadjusted and adjusted for baseline covariates such as age, BMI, history of CHD, history of stroke, left ventricular hypertrophy, diabetes mellitus, smoking, cholesterol and proteinuria. Results: Diastolic BP ≥90 mmHg but not diastolic BP Conclusions: Patients in BP strata ≥140/90 mmHg, but not patients in BP strata