Low Blood Pressure Levels May Elaboration Cardiovascular Risk Among Patients With Heart Disease In spite of Substantial Lowering Of LDL-Cholesterol
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Data from the Treating to New Targets (TNT) test presented at the American Native land of Hypertension's Twenty Fourth Annual Scientific Buzz session (ASH 2009) parade that low blood impact levels may prompt to increased risk of cardiovascular events, including heart defilement and stroke. These information supplement preceding findings from the TNT trial of atorvastatin showing aggressive LDL cholesterol-lowering reduced cardiovascular events.
Previous statistical analyzes charting cardiovascular events have found a J-curve relationship exists between blood strength and coming up cardiovascular events, where higher events were seen at the as well low and very high blood pressure levels. However, there is some debate about the proportions of this consociation in patients with intensive state of other cardiovascular risk factors, such as LDL-cholesterol.
In this study, researchers analyzed a complete of 10,001 patients with coronary artery disease (CAD) who received either 10 mg of atorvastatin (n=5,006) or 80 mg of atorvastatin diurnal (n=4,995) for a primary composite endpoint of afterlife from coronary disease, nonfatal myocardial infarction (MI), resuscitation after cardiac arrest, fatal or nonfatal stroke.
The association between systolic blood pressure (SBP) or diastolic blood vigour (DBP) and major cardiovascular events followed a J-curve with increased event rates above and below reference BP ranges (SBP 130-140 mm Hg and DBP 70-80 mm Hg). A non-linear Cox model identified a blood pressure of 140.6 mm Hg for SBP and 79.8 mm Hg for DBP where the affair ratio was lowest. The risk of big cardiovascular event increased 3.1-fold in the group with SBP â 110 mm Hg and 3.3-fold in the group with DBP â 60 mm Hg. A resembling J-curve relationship was initiate for the secondary endpoints of all-cause mortality, cardiovascular mortality, non-fatal MI and non-fatal stroke.
Study authors concluded that among a high-risk population with CAD enrolled in the TNT trial, despite substantial lowering of LDL-cholesterol, a J-curve accord existed between both systolic and diastolic BP and the risk of future cardiovascular events, suggesting that low BP levels may be harmful.
"Our findings negate the dictum that with blood pressure, lower is always better," said study co-author Franz Messerli, M.D., director, Hypertension Programme at St. Luke's-Roosevelt Hospital, Advanced York, NY. "As we learn augmented approximately the corollary of blood force on cardiovascular risk, we continually refine our sympathetic of the optimal treatment and blood pressure targets for these patients."
American Society of Hypertension
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