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. For systolic BP the HR nadir increased with increasing age: 115mmHg up to 70 years, 135mmHg for In ONTARGET involving 25,588 patients with athero- sclerotic disease or diabetes with organ damage, a J-shaped relationship between on-treatment systolic BP (nadir around 130 mm Hg) and all outcomes except stroke was observed in a Data from IDNT showed that a systolic BP below 120 mmHg was associated with an increased risk of cardiovascular deaths and congestive heart failure, but not myocardial infarction in hypertensive type 2 diabetics.228 Finally, in the ACCORD study, while targeting a systolic BP of o120 mm Hg rather than o140 mm Hg did not reduce cardiovascular outcomes, serious adverse events occurred in 3.3% of the lower BP group compared with 1.3% (po0.001) in the higher BP target group indicating the potential penalty paid for aggressive BP reduction.159 In CKD ND patients, there is observational evidence from two community-based longitudinal studies including 1549 subjects with CKD 3-4. 