We identified significant risk effects of SBP on hypertensive disease (OR = 4.38), dyslipidemia (OR = 1.50), CVD (OR = 1.40) and disease count (OR = 1.43) in the community data, and CAD (OR = 1.73) in the case–control data. The results for SBP and DBP were highly concordant (Fig. 2; Supplementary Fig. 10c). The risk effect of blood pressure on CAD is known to be causal as confirmed by RCTs46,47. Note that the power of the GSMR analysis for blood pressure was likely to be limited given the small number of instruments used (m < 30).