Low BP may increase the risk of cardiovascular events in patients with coronary artery disease (CAD), despite substantial lowering of LDL cholesterol, according to new findings.

The finding emerged from a study of 10,001 CAD patients who received 10 mg or 80 mg of atorvastatin daily as part of the Treating to New Targets study. The primary end point was a composite of death from coronary disease, nonfatal MI, resuscitation after cardiac arrest, and fatal or nonfatal stroke.

Compared with patients who had a systolic BP (SBP) of 130-140 mm Hg or diastolic BP (DBP) of 70-80 mm Hg, those with an SBP of 110 mm Hg or less or a DBP of 60 mm Hg or less had a threefold increased risk of the composite end point.

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“Our findings negate the dictum that with blood pressure, lower is always better,” said co-investigator Franz Messerli, MD, Director of the Hypertension Program at St. Luke’s-Roosevelt Hospital in New York.