The J-point phenomenon in aggressive therapy of hypertension: New insights

Authors

Gurusher S. Panjrath, The Johns Hopkins Hospital
Sameer Chaudhari, Good Samaritan Hospital Baltimore
Franz H. Messerli, Vagelos College of Physicians and Surgeons

Document Type

Journal Article

Publication Date

4-1-2012

Journal

Current Atherosclerosis Reports

Volume

14

Issue

2

DOI

10.1007/s11883-012-0233-4

Keywords

Coronary artery disease; Diastolic blood pressure; Hypertension; Mortality; Myocardial infarction; Stroke

Abstract

In the era of aggressive control of cardiovascular risk factors such as hypertension, the mantra of "lower is better" has taken a strong foothold. Although there is clear epidemiologic evidence that lower blood pressure improves specific organ-related outcomes, this rule does not apply to all patients and definitely not all target organs. The concept of J-curve or adverse outcomes at lower blood pressure has been proposed for more than three decades but has recently come under increasing scrutiny. Specifically, a relationship between adverse cardiovascular outcomes and low diastolic blood pressure has been observed in multiple clinical trials. In this article we review the advances in understanding of the J-curve phenomenon and include a discussion on specific populations that might be at higher risk due to the J-curve relationship. © Springer Science+Business Media, LLC 2012.

APA Citation

Panjrath, G., Chaudhari, S., & Messerli, F. (2012). The J-point phenomenon in aggressive therapy of hypertension: New insights. Current Atherosclerosis Reports, 14 (2). http://dx.doi.org/10.1007/s11883-012-0233-4