ArticleInternational journal of cardiology2019
Mechanisms underlying the J-curve for diastolic blood pressure: Subclinical myocardial injury and immune activation.
Article in International journal of cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 10 citations in OpenAlex.
- Natriuretic peptides and cardiac troponins in hypertension and heart failure: A contemporary review of the evidence.Journal of human hypertension · 2026Review
- Diastolic blood pressure as a predictor of short-term mortality in infective endocarditis.International journal of cardiology. Cardiovascular risk and prevention · 2025Article
- Non-linear association and benchmark dose of blood pressure on carotid artery intima-media thickening in a general population of southern China.Frontiers in cardiovascular medicine · 2024Article
- Unsolved Problem: (Isolated) Systolic Hypertension with Diastolic Blood Pressure below the Safety Margin.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2020Review
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16 authors at 3 institutions in 1 country.
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Abstract
backgroundLow diastolic blood pressure (DBP) is associated with increased risk of cardiovascular events. In patients with coronary artery disease (CAD), limitations in coronary blood flow and immune activity are implicated mechanisms, but evidence is lacking. We investigated the association between DBP, biomarkers of myocardial injury, inflammation, immune activation and incident events in patients with CAD.
methodsWe studied 2448 adults (mean age 65 ± 12 years, 68% male, median follow-up 4.5 years) with CAD. DBP was categorized into 10 mm Hg increments. Biomarkers of myocardial injury (high sensitivity cardiac troponin-I [hs-cTnI]) and immune activity/inflammation (soluble urokinase plasminogen activator receptor [suPAR]) were dichotomized at their median values. DBP 70-79 mm Hg was used as the referent group, and individuals were followed prospectively for adverse outcomes.
resultsAfter adjusting for demographic and clinical covariates, individuals with DBP < 60 mm Hg had increased odds of elevated levels of hs-cTnI (OR = 1.68; 95% CI = 1.07, 2.65) and suPAR (OR = 1.71; 95% CI = 1.10, 2.65) compared to the referent group. Additionally, DBP < 60 mm Hg was associated with increased adjusted risk of cardiovascular death or MI (HR = 2.04; 95% CI = 1.32, 3.16) and all-cause mortality (HR = 2.41; 95% CI = 1.69, 3.45).
conclusionIn patients with CAD, DBP < 60 mm Hg is associated with subclinical myocardial injury, immune/inflammatory dysregulation and incident events. Aggressive BP control may be harmful in these patients, and further investigation is warranted to determine appropriate BP targets in patients with CAD.
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