Blood Pressure and the J-Curve Phenomenon

In patients with hypertension and coronary artery disease, a J-curve was evident for the relation between BP and adverse outcomes, but the relation was attenuated after adjustment for baseline factors.

Given that coronary blood flow occurs during diastole, hypertensive people with coronary artery disease (CAD) might be more sensitive than those without CAD to diastolic blood pressure reductions. In a secondary analysis of data from an earlier study (Journal Watch Dec 23 2003), researchers evaluated the relation between BP and cardiovascular outcomes among 22,576 patients with CAD and hypertension who were treated with atenolol or sustained-release verapamil.

At baseline, patients with lower diastolic BP (DBP) were older and had higher rates of previous myocardial infarction, heart failure, and diabetes than those with higher DBP. After a median follow-up of 2.7 years, a J-shaped curve — with worse outcomes both above and below an optimal B…

Reviewing Author

Jamaluddin Moloo, MD, MPH

Blood Pressure and the J-Curve Phenomenon

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Reviewing Author