ArticleInternational journal of hypertension2013
Low Diastolic Blood Pressure as a Risk for All-Cause Mortality in VA Patients.
Article in International journal of hypertension, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Clinical trial of home blood pressure monitoring following midodrine administration in hypotensive individuals with spinal cord injury.The journal of spinal cord medicine · 2023Trial
- Sit-up test to assess orthostatic hypotension in individuals with spinal cord injury.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Observational
- Factors associated with unfavorable outcomes in patients with acute abdominal pain visiting the emergency department.BMC emergency medicine · 2022Article
- The optimal pulse pressures for healthy adults with different ages and sexes correlate with cardiovascular health metrics.Frontiers in cardiovascular medicine · 2022Article
- Do clinical and paraclinical findings have the power to predict critical conditions of injured patients after traumatic injury resuscitation? Using data mining artificial intelligence.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2021Article
- Predictors of intra-hospital mortality in patients with diabetic foot ulcers in Nigeria: data from the MEDFUN study.BMC endocrine disorders · 2020Observational
- Article
- Hypotension and a positive fluid balance are associated with delirium in patients with shock.PloS one · 2018Article
- Thus Far and No Further: Should Diastolic Hypotension Limit Intensive Blood Pressure Lowering?Current treatment options in cardiovascular medicine · 2017Review
- Prevalence of abnormal systemic hemodynamics in veterans with and without spinal cord injury.Archives of physical medicine and rehabilitation · 2015Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background. A paradoxical increase in cardiovascular events has been reported with intensively lowering diastolic blood pressure (DBP). This J-curve phenomenon has challenged the aggressive lowering of blood pressure, especially in patients with coronary artery disease. Objective. Our objective was to study the effects of low DBP on mortality and determine a threshold for which DBP should not be lowered beyond. Methods. We evaluated a two-year cross-section of primary care veteran patients, from 45 to 85 years of age. Receiver operating characteristics (ROC) were employed to establish an optimal cut-off point for DBP. Propensity-score matching and multivariate logistic regression were used to control for confounders. All-cause mortality was the primary outcome. Results. 14,270 patients were studied. An ROC curve found a threshold value of DBP 70 mmHg had the greatest association with mortality (P < 0.001). 49% of patients had a DBP of 70 mmHg or less. Using a propensity-matched multivariate logistic regression, odds ratio for all-cause mortality in subjects with a DBP less than 70 mmHg was 1.5 (95% CI 1.3-1.8). Conclusions. Reduction of DBP below 70 mmHg is associated with increased all-cause mortality. Hypertension guidelines should include a minimum blood pressure target.
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Registered trials
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