Document Detail

The J Curve Revisited: A Therapeutic Dilemma.
MedLine Citation:
PMID:  22447043     Owner:  NLM     Status:  Publisher    
The J-curve in hypertension treatment refers to the relationship between achieved diastolic blood pressure and cardiovascular morbidity and mortality, specifically related to coronary heart disease (CHD). As diastolic blood pressure decreases below a certain threshold or nadir, the risk of cardiovascular events increases. This phenomenon was first described over 30 years ago and its significance has been debated ever since. We review in detail the literature for and against the existence of this J-curve and discuss its purported pathophysiology. Most notably, recent post hoc analyses of large contemporary randomized trials in patients with documented CHD strongly support its existence. Given the current emphasis on strict blood pressure control, especially in high-risk patients like those with CHD, diabetes, and chronic kidney disease, we discuss the implications this J-curve may have for treating hypertension in the individual patient.
Edward J Filippone; Andrew Foy
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-22
Journal Detail:
Title:  Cardiology in review     Volume:  -     ISSN:  1538-4683     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9304686     Medline TA:  Cardiol Rev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
*Department of Medicine, Division of Nephrology, Thomas Jefferson University, Philadelphia, Pa **Department of Medicine, Division of Cardiology, Penn State Milton S Hershey Medical Center, Hershey, Pa.
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