ArticleThe American journal of cardiology2017
Relation of Diastolic Blood Pressure and Coronary Artery Calcium to Coronary Events and Outcomes (From the Multi-Ethnic Study of Atherosclerosis).
Article in The American journal of cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 34 citations in OpenAlex.
- Handgrip and Acute Hemodynamic Responses During Cyclic Exercise: Randomized Clinical Trial.Journal of clinical hypertension (Greenwich, Conn.) · 2026Trial
- Diastolic Blood Pressure and Adverse Outcomes in the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) Trial.Journal of the American Heart Association · 2018Trial
- Blood Pressure Control and Mortality Among US Veterans.Hypertension (Dallas, Tex. : 1979) · 2026Article
- Multimodal assessment of arterial stiffness using photoplethysmography and laser Doppler flowmetry.NPJ cardiovascular health · 2026Article
- Single-beat method echocardiographic comparison of ventricular-arterial coupling in adults with and without Down syndrome.American journal of physiology. Heart and circulatory physiology · 2026Article
- Age-specific associations between blood pressure and cardiovascular disease, kidney disease, and death among individuals with type 2 diabetes: a population-based cohort study.Cardiovascular diabetology · 2026Article
- Blood pressure management in secondary prevention after myocardial infarction.Cardiovascular research · 2025Review
- Review of Blood Pressure Control in Vulnerable Older Adults: The Role of Frailty and Sarcopenia.Journal of vascular diseases · 2025Article
- Association of diastolic blood pressure and coronary artery calcium in South Asian American adults.Journal of hypertension · 2025Article
- A retrospective single-centre study on determinants of high-risk coronary artery calcium (CAC) score in women.The British journal of cardiology · 2024Article
- Article
- Expert consensus on blood pressure management in critically ill patients.Journal of intensive medicine · 2023Article
- Clinical Significance of Mean and Pulse Pressure in Patients With Heart Failure With Preserved Ejection Fraction.Hypertension (Dallas, Tex. : 1979) · 2022Article
- The diastolic blood pressure J-curve revisited: An update.American heart journal plus : cardiology research and practice · 2021Review
- Usefulness of Ankle-Brachial Index Calculated Using Diastolic Blood Pressure and Mean Arterial Pressure in Predicting Overall and Cardiovascular Mortality in Hemodialysis Patients.International journal of medical sciences · 2021Observational
- Article
- Usefulness of ankle-brachial index calculated using diastolic blood pressure for prediction of mortality in patients with acute myocardial infarction.Journal of clinical hypertension (Greenwich, Conn.) · 2020Article
- Association of Isolated Diastolic Hypertension Based on the Cutoff Value in the 2017 American College of Cardiology/American Heart Association Blood Pressure Guidelines With Subsequent Cardiovascular Events in the General Population.Journal of the American Heart Association · 2020Observational
- Coronary artery calcium scoring in patients with hypertension.Journal of human hypertension · 2020Review
- Usefulness of four-limb blood pressure measurement in prediction of overall and cardiovascular mortality in acute myocardial infarction.International journal of medical sciences · 2020Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
Diastolic blood pressure has a J-curve relation with coronary heart disease and death. Because this association is thought to reflect reduced coronary perfusion at low diastolic blood pressure, we hypothesized that the J-curve would be most pronounced in persons with coronary artery calcium. In 6,811 participants from the Multi-Ethnic Study of Atherosclerosis, we used Cox models to examine if diastolic blood pressure category is associated with coronary heart disease events, stroke, and mortality. Analyses were conducted in the sample overall and after stratification by coronary artery calcium score. In multivariable-adjusted analyses, compared with diastolic blood pressure of 80 to 89 mm Hg (reference), persons with diastolic blood pressure <60 mm Hg had increased risk of coronary heart disease events (hazard ratio 1.69 [95% confidence interval 1.02 to 2.79]) and all-cause mortality (hazard ratio 1.48 [95% confidence interval 1.10 to 2.00]), but not stroke. After stratification, associations of diastolic blood pressure <60 mm Hg with events were present only in participants with coronary artery calcium >0. Diastolic blood pressure <60 mm Hg was not associated with events when coronary artery calcium was zero. However, the association between diastolic blood pressure and events did not demonstrate statistical interaction when stratified by presence or absence of coronary calcium. We also found no interaction in the association between low diastolic blood pressure and events based on race. In conclusion, diastolic blood pressure <60 mm Hg was associated with increased risk of coronary heart disease events and all-cause mortality in the sample overall, but this association appeared strongest in individuals with subclinical atherosclerosis.
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