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Response by McEvoy and Blaha to Letter Regarding Article, "Coronary Artery Calcium to Guide a Personalized Risk-Based Approach to Initiation and Intensification of Antihypertensive Therapy".

We thank Harbaoui and colleagues for their interest in our recent publication in Circulation .1 Their letter raises important points but also necessitates that we clarify others.

We agree that pulse pressure and diastolic blood pressure (BP) are important clinical parameters to consider when targeting intensive systolic BP goals in high-risk adults. We have recently published on this very issue.2 We also agree that some individuals with elevated coronary artery calcium (CAC) may be more susceptible to myocardial ischemia when undergoing intensive systolic BP reduction because of the baseline presence of wide pulse pressure and low diastolic BP …