ReviewCurrent cardiology reports2003
The J-curve in hypertension.
Review in Current cardiology reports, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed.
- Coronary perfusion pressure is associated with adverse outcomes in advanced heart failure.Perfusion · 2023Trial
- The Eyeball Test.Ochsner journal · 2023Article
- J-shaped curve for cardiovascular mortality: systolic or diastolic blood pressure?Journal of nephrology · 2019Review
- Does a blood pressure J curve exist for patients with chronic kidney disease?Journal of clinical hypertension (Greenwich, Conn.) · 2017Review
- How lifespan associated genes modulate aging changes: lessons from analysis of longitudinal data.Frontiers in genetics · 2013Article
- Diastolic blood pressure levels and ischemic stroke incidence in older adults with white matter lesions.The journals of gerontology. Series A, Biological sciences and medical sciences · 2011Article
- The optimal blood pressure target for patients with coronary artery disease.Current cardiology reports · 2010Review
- Adrenal insufficiency after brain injury.Intensive care medicine · 2006Article
- Dispelling the myth of "aggressive" antihypertensive therapy.Journal of clinical hypertension (Greenwich, Conn.) · 2006Review
- Clinical trials report. Hypertensive diabetic patients: INVESTing in the prevention of cardiovascular disease.Current hypertension reports · 2005Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The J-curve debate has continued for 25 years. Dependency upon observational and retrospective studies has confused the issue; only the full publication of data from the prospective, randomized Hypertension Optimal Treatment (HOT) study has thrown genuine light on the problem. Many examples of the J-curve relationship between blood pressure and cardiovascular/noncardiovascular events are due to reverse causality, where underlying disease (eg, poor left ventricular function, poor general health, poorly compliant/stiff arteries) is the cause of both the low blood pressure and the increased risk of both cardiovascular and noncardiovascular events. The J-curve in patients with stiff arteries (wide pulse pressure) may be exacerbated by treatment. From the full publication of the HOT study database it is now reasonable to conclude that for nonischemic hypertensive subjects the therapeutic lowering of diastolic blood pressure (DBP) to the low 80s mm Hg is beneficial, but it is safe (though unproductive) to go lower. However, in the presence of coronary artery disease (limited coronary flow reserve) there is a J-curve relationship between treated DBP and myocardial infarction, but not for stroke. In such high-risk (for myocardial infarction) cases it would be prudent to avoid lowering DBP to below the low 80s mm Hg.
Indexed as
Identifiers
14558984What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.