Iftekhar Uddin SM, et al. - Whether coronary artery calcium (CAC) is useful for cardiovascular risk stratification among hypertensive adults, including those meeting inclusion criteria for the Systolic Blood Pressure Intervention Trial (SPRINT), was investigated. From the CAC Consortium, 16,167 hypertensive patients were included; 6,375 formed a “SPRINT-like” population. Increased coronary heart disease and cardiovascular disease (CVD) mortality were observed in association with increasing CAC scores. Across 10-year atherosclerotic CVD risk categories and in the SPRINT-like population, similarly elevated risk was found. Overall, risk stratification of adults with hypertension, including those who were SPRINT eligible, was enabled by CAC. Hypertensive adults with SPRINT-level CVD mortality risk could be detected by a CAC score of 220, which also appeared reasonable for detecting subjects who might benefit from aggressive blood pressure therapy.