The J-Curve in Arterial Hypertension: Fact or Fallacy?

Abstract

It is known that a large proportion of patients with arterial hypertension are undertreated. This may result in an increase of the incidence of cardiovascular events. On the other hand, aggressive reduction of blood pressure may increase cardiovascular events (J-curve phenomenon) in certain populations. This phenomenon may be seen in patients with coronary artery disease and left ventricular hypertrophy when the diastolic blood pressure decreases below 70-80 mm Hg, and the systolic blood pressure decreases below 130 mm Hg. This phenomenon is not seen in patients with stroke or renal disease. Thus, a safer and more conservative strategy should be applied in patients with coronary artery disease, left ventricular hypertrophy, elderly, and in patients with isolated systolic hypertension. This is depicted in the recently published European Society of Hypertension/European Society of Cardiology guidelines in which higher targets of blood pressure are suggested in certain cardiovascular diseases and in the elderly.

Journal

Journal ID (publisher-id): CRD

Journal ID (nlm-ta): Cardiology

Journal ID (doi): 10.1159/issn.0008-6312

Title: Cardiology

Publisher: S. Karger AG

ISSN (Print): 0008-6312

ISSN (Electronic): 1421-9751

Publication date Subscription-year: 2014

Publication date (Print): September 2014

Publication date (Electronic): 10 September 2014

Volume: 129

Issue: 2

Pages: 126-135

Affiliations

^aCardiology Department, Asklepeion Hospital, Athens, Greece; ^bSection of Interventional Cardiology, Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio, USA

Author notes

*Evangelia P. Tsika, Cardiology Department, Asklepeion General Hospital, 1 Vasileos Paulou Street, GR-16673 Voula/Athens (Greece), E-Mail [e-mail]

Article

Publisher ID: 362381 Other ID: Cardiology 2014;129:126-135

DOI: 10.1159/000362381

PubMed ID: 25227573

Copyright statement: © 2014 S. Karger AG, Basel

License:

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Page count

Figures: 3, Tables: 3, Pages: 10

Product

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Categories

Subject: Turning Basic Research into Clinical Success