J-Curve Effect Doesn't Apply to Stroke


Traditional thinking has been that cardiac complications fall and then rise as blood pressure is lowered -- but that so-called J-curve effect apparently does not apply to stroke.

A review of 11 studies involving almost 26,000 patients followed for up to 21 years found that when diastolic blood pressure is high, cardiovascular events (including stroke) also increase. On the other hand, cardiovascular events appear to decrease if systolic blood pressure at or above 160 mmHg is lowered but start to rise if pressure is decreased to below 121 mm Hg, according to the review published online in the American Journal of Cardiology

However, the J-curve effect for cardiovascular events was missing for stroke-related complications in all the studies reviewed by Steven G. Chrysant, MD, PhD, of the University of Oklahoma, and George S. Chrysant, MD, of the University of Oklahoma Health Sciences Center in Oklahoma City.

The father and son research team suggested that their finding should prompt clinicians to limit attempts to aggressively lower blood pressure below current targets.

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