J-Shaped Relationship in Hypertension
Authors: Geza Simon
Journal: Annals of Internal Medicine (2003)

Letters7 January 2003J-Shaped Relationship in HypertensionGeza Simon, MDGeza Simon, MDVeterans Affairs Medical Center; Minneapolis, MN 55417 (Simon)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-1-200301070-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The hypothetical pathophysiologic basis of the J-shaped relationship between blood pressure and cardiovascular morbidity and mortality (J-curve) is impaired myocardial and cerebrovascular autoregulation of blood flow on the tissue level due to diseased small-resistance arteries (1, 2). Impaired autoregulation of blood flow is a complication of moderate and severe hypertension and is reversible by effective antihypertensive therapy within 1 to 2 years (2, 3). It correlates best with diastolic blood pressure and may lead to myocardial infarction or lacunar stroke when diastolic blood pressure dips below 70 mm Hg (4). To test for the presence or absence ...References1. Cruickshank JM, Thorp JM, Zacharias FJ. Benefits and potential harm of lowering high blood pressure. Lancet. 1987;1:581-4. [PMID: 2881129] CrossrefMedlineGoogle Scholar2. Strandgaard S. Autoregulation of cerebral blood flow in hypertensive patients. The modifying influence of prolonged antihypertensive treatment on the tolerance to acute, drug-induced hypotension. Circulation. 1976;53:720-7. [PMID: 815061] CrossrefMedlineGoogle Scholar3. MacMahon S, Rodgers A, Neal B, Chalmers J. Blood pressure lowering for the secondary prevention of myocardial infarction and stroke [Editorial]. Hypertension. 1997;29:537-8. [PMID: 9040434] CrossrefMedlineGoogle Scholar4. Somes GW, Pahor M, Shorr RI, Cushman WC, Applegate WB. The role of diastolic blood pressure when treating isolated systolic hypertension. Arch Intern Med. 1999;159:2004-9. [PMID: 10510985] CrossrefMedlineGoogle Scholar5. Boutitie F, Gueyffier F, Pocock S, Fagard R, Boissel JP. J-shaped relationship between blood pressure and mortality in hypertensive patients: new insights from a meta-analysis of individual-patient data. Ann Intern Med. 2002;136:438-48. [PMID: 11900496] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Veterans Affairs Medical Center; Minneapolis, MN 55417 (Simon) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoJ-Shaped Relationship between Blood Pressure and Mortality in Hypertensive Patients: New Insights from a Meta-Analysis of Individual-Patient Data Florent Boutitie , François Gueyffier , Stuart Pocock , Robert Fagard , Jean Pierre Boissel , and Metrics Cited ByBlood pressure and mortality among Chinese patients with cardiovascular disease 7 January 2003Volume 138, Issue 1Page: 78KeywordsBlood flowBlood pressureDatabasesFallsHeart failureHypertensionMorbidityMortalityMyocardial infarctionStatistical data ePublished: 7 January 2003 Issue Published: 7 January 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...