In contrast, the decrease in the risk of MI approached but did not achieve statistical significance.157 In ONTARGET, the benefits from lowering SBP to <130 mmHg were driven mostly by a reduction in stroke. MI was unaffected and cardiovascular mortality was unchanged.90 There is consistency in these reports, namely that inten- sive BP lowering to <130/80 mmHg does not significantly decrease or increase coronary morbidity or mortality but may be protective against stroke. However, the PROFESS data are different, so the issue is still somewhat moot. 3.2.6. The Elderly It might be predicted that a J curve would have a more dev- astating effect on elderly individuals, with a nadir at higher pressures, because of the greater likelihood of their having CAD and a lower coronary reserve. Very few studies have addressed this question, but those that have addressed it have produced reasonably reassuring results. An INVEST sub- showed a J-shaped relationship between DBP and the primary outcome (all-cause death, nonfatal MI, or nonfa- tal stroke) but with a nadir of 75 mmHg, except for the very old, for whom it was even lower at 70 mmHg. In HYVET,15 patients >80 years of age with a mean BP of 173.0/90.8 mmHg were randomized to receive treatment with indap- amide, with perindopril added if necessary, versus placebo. In the active treatment group, the mean BP fell by almost 30/13 mmHg and produced a 30% reduction in stroke and a 64% reduction in HF but had no significant effect on MI. 