Blood pressure levels below and above a nadir of 143/82 mm Hg followed a J-curve association with increased rates of new vascular events and all-cause mortality in patients with vascular disease.
Cohort (n=5,788)
Does blood pressure level have a J-curve relationship with vascular events and mortality in patients with manifest vascular disease?
In patients with manifest vascular disease, blood pressure exhibits a J-curve relationship with recurrent events and mortality, with a nadir at 143/82 mm Hg, challenging aggressive BP lowering targets.
Recent studies have challenged the notion that "lower is better" for blood pressure in relation to vascular events and mortality in patients with vascular disease, whereas practice guidelines currently recommend to lower blood pressure to 60 mm Hg pulse pressure. Importantly, especially in these subgroups, low blood pressure could also be a symptom rather than a cause of disease. Blood pressure level below and above 143/82 mm Hg is, thus, an independent risk factor for recurrent events in patients with manifest vascular disease. Uncertainty of whether this association is causal provides a strong rationale for trials evaluating blood pressure treatment targets.
Dorresteijn et al. (Tue,) conducted a cohort in symptomatic vascular disease (n=5,788). Blood pressure was evaluated on new vascular events (myocardial infarction, stroke, or vascular death) and all-cause mortality. Blood pressure levels below and above a nadir of 143/82 mm Hg followed a J-curve association with increased rates of new vascular events and all-cause mortality in patients with vascular disease.
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