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div>In this study, 25,588 patients were enrolled in a multicenter, double-blinded randomized trial in 40 countries. The study enrolled patients older than 55?years with coronary, peripheral, or cerebrovascular disease or diabetes with end-organ damage. They were randomized to ramipril, telmisartan, or both. The primary outcome of the Panobinostat in vitro study was a composite of cardiovascular death, myocardial infarction (MI), stroke, or hospitalization for heart failure. The primary composite outcome was related to baseline SBP: SBP changes from baseline to event and average in-trial SBP. The results showed that the risk of myocardial infarction did not increase with baseline SBP and was unaffected by subsequent SBP change. In contrast, stroke risk progressively increased with baseline SBP and decreased with reduction. In patients with baseline SBP <130?mm?Hg, cardiovascular mortality increased with further SBP reduction. A J curve (nadir around 130) (Figure?2) occurred in the relationship between in-treatment SBP and all outcomes except stroke.16 The conclusion of this study was that in high-risk patients, the benefits from SBP-lowering <130?mm?Hg are determined by a reduction of stroke, myocardial infarction Paclitaxel concentration is unchanged, and cardiovascular mortality is unaffected or increased. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) BP trial arm17 evaluated the effect of targeting an SBP of 120?mm?Hg, as compared with a goal of 140?mm?Hg, among patients with type 2 diabetes Sitaxentan at high risk for cardiovascular events. A total of 4733 participants were randomly assigned to intensive therapy (BP <120?mm?Hg) or standard therapy (BP <140?mm?Hg), with the mean follow-up being 4.7?years. The intensive antihypertensive therapy in the ACCORD BP trial did not considerably reduce the primary cardiovascular outcome or the rate of death from any cause. The intensive arm of BP control reduced the rate of total stroke and nonfatal stroke. In this context, the estimated number needed to treat with intensive BP therapy to prevent one stroke over 5?years was 89. There were indicators of possible harm associated with intensive BP control (systolic <120?mm?Hg), including a rate of serious adverse events in the intensive arm. The observational subgroup analysis of the International Verapamil SR-Trandolapril Study (INVEST) was published in 2010.18 Participants in this study were at least 50?years old and had diabetes and coronary artery disease. Patients received a first-line therapy of either a calcium antagonist or ��-blocker followed by an ACE inhibitor, a diuretic, or both to achieve SBP <130?mm?Hg and DBP <85?mm?Hg. The study had 3 groups: tight control, SBP <130?mm?Hg; usual control, between 140 mm Hg to 130?mm?Hg; and uncontrolled, ��140?mm?Hg. Patients in the usual control group (140�C130?mm?Hg) had a cardiovascular event rate of 12.6% vs 19.