BACKGROUND Coronary Artery Disease (CAD) has emerged as the single most important cause of death worldwide in the past decade. Hypertension, both systolic and diastolic are among the major coronary artery disease risk factors. However, the relation between low diastolic blood pressure and severity of CAD is yet to be established. The aim of the present study is to assess the association of low diastolic blood pressure (DBP) levels with high atherosclerotic burden in coronary artery disease (CAD) patients. METHODS Among the 184 patients who underwent diagnostic cardiac catheterization at Cardiology Department, King George Hospital, Visakhapatnam between Feb-2018 to July-2018, we included 50 patients who satisfied our inclusion criteria. RESULTS In our study, out of 50 coronary artery disease patients enrolled in the study, 34 members (68%) were males and remaining 16 members (32%) were female patients. From the results, we observed that the prevalence of CAD was higher in male population compared to female population. CONCLUSIONS CAD was predominant in males than in females. In coronary artery disease patients, a low DBP had an independent significant association with increasing the atherosclerotic burden in coronary arteries, identified by high SYNTAX Score. A DBP <70 mmHg in CAD patients further worsens the disease severity and complexity. HOW TO CITE THIS ARTICLE: Hemamalini KP, Veera Raghavulu B, Annapurna A, et al. The association between low diastolic blood pressure and high athero-sclerotic vascular burden in patients with coronary artery disease.