A strong association between baseline BP and subsequent risk of kidney failure was also demonstrated in an Okinawan After adjustment for age and BMI, there was a significant, positive association between systolic BP and the risk of diabetic kidney failure, with a relationship also demonstrated for diastolic BP in women only. The Pittsburg Epidemiology of Diabetes Complications reported on 589 patients with childhood- onset diabetes. A graded association between baseline BP and subsequent risk of major events was found. Data from the Cardiovascular Health Study and the Atherosclerosis Risk In Communities study158 showed that among participants with CKD, there was a J-shaped relationship between systolic BP and risk of stroke, with a higher risk of stroke with a systolic BP o120 mm Hg; this relationship was not seen in those without CKD. Post hoc analyses of RCTs. Post hoc analyses of several large RCTs have indicated various relationships between achieved BP and outcomes. A post hoc analysis of achieved BP and outcome in the Irbesartan Diabetic Nephropathy Trial (IDNT)228 indicated that systolic BP o120 mm Hg was associated with an increased (rather than decreased) risk of cardiovascular events. A post hoc analysis of UKPDS 36,229 irrespective of treatment allocation, revealed a significant association between higher systolic BP and higher risk of clinical complications over a systolic BP range of 115 to 170 mm Hg. The International Verapamil SR Trandolapril (INVEST) study recruited patients with hypertension and CAD and compared the effects of verapamil and atenolol. Trandolapril, hydrochlorothiazide, or both were added to achieve either a BP o140/90mm Hg or a BP of o130/85mm Hg in patients with diabetes or kidney impairment.230 In an analysis of achieved BP among participants with diabetes (irrespective of their rando- mized treatment assignments), those who achieved tight BP control (i.e.