1. Diastolic Blood Pressure J-Curve Phenomenon in a Tertiary-Care Hypertension Clinic
- Author
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Stefanie Lip, Panniyammakal Jeemon, Sandosh Padmanabhan, Linsay McCallum, Anna F. Dominiczak, and Li En Tan
- Subjects
Adult ,Male ,medicine.medical_specialty ,hypertension ,Myocardial Infarction ,heart failure ,Blood Pressure ,Disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Diastole ,Risk Factors ,Internal medicine ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Myocardial infarction ,Prospective cohort study ,Stroke ,Antihypertensive Agents ,Aged ,Hypertension clinic ,Tertiary Healthcare ,business.industry ,Epidemiology/Population Science ,Hazard ratio ,Blood Pressure Determination ,Original Articles ,Middle Aged ,medicine.disease ,Survival Rate ,myocardial ischemia ,Blood pressure ,Heart failure ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Cardiology ,Female ,business - Abstract
Supplemental Digital Content is available in the text., Concerns exist regarding the potential increased cardiovascular risk from lowering diastolic blood pressure (DBP) in hypertensive patients. We analyzed 30-year follow-up data of 10 355 hypertensive patients attending the Glasgow Blood Pressure Clinic. The association between blood pressure during the first 5 years of treatment and cause-specific hospital admissions or mortality was analyzed using multivariable adjusted Cox proportional hazard models. The primary outcome was a composite of cardiovascular admissions and deaths. DBP showed a U-shaped association (nadir, 92 mm Hg) for the primary cardiovascular outcome hazard and a reverse J-shaped association with all-cause mortality (nadir, 86 mm Hg) and noncardiovascular mortality (nadir, 92 mm Hg). The hazard ratio for the primary cardiovascular outcome after adjustment for systolic blood pressure was 1.38 (95% CI, 1.18–1.62) for DBP
- Published
- 2019
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