Izzo R, Mancusi C, De Stefano G, et al. - Since there is evidence of the harmful impact of reducing DBP too much, researchers examined 4,005 treated hypertensive patients (22% obesity, 8% diabetes and 21% current smoking habit) with target attended office SBP less than 140 mmHg to assess the impact of DBP quintiles, cardiovascular risk profile, and target organ damage (LV hypertrophy, carotid plaque and left atrial dilatation) on the outcome in these patients. Independently of a significant influence of older age, female sex, LV hypertrophy, and borderline impact of left atrial dilatation, a 1.49 higher risk of composite cardiovascular events was reported in relation to the lowest quintile of DBP. To predict the net benefit of antihypertensive therapy, particularly in the oldest old individuals, experts recommended balancing the increased risk related to the aggressive lowering of DBP with the benefit of aggressive lowering of SBP.