HypertensionMeta-analysis
Blood pressure lowering in isolated diastolic hypertension and cardiovascular risk: an individual patient data meta-analysis
- Individual participant data meta-analysis of randomised controlled trials
- fixed-effect one-stage
- Cox models stratified by trial
Authors' conclusion
The study found no evidence to suggest that pharmacological BP-lowering therapy in individuals with IDH is less or more effective than in those without IDH.
Study context
- Population
- Participants in blood pressure (BP)-lowering RCTs, with and without isolated diastolic hypertension
- Participants
- 358,325 participants · 51 RCTs
- Comparison
- BP lowering in isolated diastolic hypertension (IDH) vs no IDH
- IDHn = 15,845
- Outcome
- Major CV events per 5 mmHg reduction in SBP
- Follow-up
- Median 4.2 years
Pooled result
As reported in the abstract
Major CV events per 5 mmHg SBP reduction
Hazard ratio (95% CI)
IDH
0.91(0.82–1.01)
Without IDH
0.90(0.89–0.92)
Per 5 mmHg SBP reduction, as printed
Further pooled results
Major CV events by baseline DBP (<60 to ≥90 mmHg), SBP < 130 mmHg
- No evidence of heterogeneity in treatment effects
- P for interaction = .26
Relative treatment effects by cardiovascular disease (CVD) history, age, prior medication, BP measurement method
- Not statistically different
Original publication
Blood pressure lowering in isolated diastolic hypertension and cardiovascular risk: an individual patient data meta-analysis. Eur Heart J. Published 12 December 2025. doi:10.1093/eurheartj/ehaf962
Summarised from the published abstract; every number is checked against it