Blood pressure: vascular death is not all-cause death

The curve is a constructed joint rule (120/80 = 1.0; confidence LOW). Below both readings the curve is flat at HR 1.0 — no reward, changed 2026-09-10 per Wang et al. 2026 (UK Biobank, 80,730 adults screened free of traditional CV risk factors: usual SBP <114 carried HR 1.16, 1.02–1.32, versus 120–126, the opposite sign from the old bonus); when either number is high it takes the worse penalty (+8% per 10 mmHg SBP or per 5 mmHg DBP). No paper specifies that high-side combination. Lewington’s 2002 source is more than 10 years old. The overlay is Lewington 2002: ages 40–69, each 20/10 mmHg usual BP ≈ twofold vascular death, down to 115/75 — vascular, not all-cause, and ~2.0 per 20 mmHg is not this calculator’s 1.08 per 10. No matching-construct usual office/home BP → all-cause mortality continuous general-population meta-analysis is available. Treatment all-cause mortality exists and is a different design: Ettehad RR 0.87 per 10 mmHg SBP reduction; Bundy all-cause mortality HR 0.73 at achieved 120–124 vs 130–134; Brunström primary-prevention all-cause mortality neutral below baseline 140 (RR 0.98). SPRINT intensive all-cause mortality HR 0.73 during the trial; Jaeger: that benefit did not persist after intensity lapsed (8.8 y all-cause mortality HR 1.08).