Perhaps surprisingly, a low diastolic BP on treatment was associated with an increased risk of stroke, coronary heart disease and CVD.41 Likewise in INVEST, a multi-national RCT comparing verapamil sustained-release and atenolol-based treatment in 22,576 patients with hypertension and CAD, BP control and outcomes were equivalent between the groups, but the risk of the primary outcome (all-cause death, non-fatal myocardial infarction and non-fatal stroke) progressively increased with a BP lower than 119/84mmHg, although taken alone, stroke risk did not increase with lower BP. After adjustment for multiple variables the relationship between low diastolic BP and primary outcome Further analysis of the above association including only the 2699 patients with peripheral artery disease also showed a J-shaped relationship, such that the primary outcome occurred least frequently at a systolic BP of 135-145mmHg and a diastolic BP of 60-90mmHg, with the effect most strongly related to Stratifying patients into those aged o60, 60 to o70, 70 to o80 and Z80 years and plotting survival versus diastolic BP produced a pronounced J-curve effect with a HR nadir at 75mmHg up to 80 years, then 70mmHg for subjects 480 years. 