Antihypertensive Therapy and the J-curve: Fact or Fiction?
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- 作者：Monique S. Tanna ; Sripal Bangalore
- 关键词：Antihypertensive treatment ; Blood pressure target ; Hypertension ; J ; curve
- 刊名：Current Hypertension Reports
- 出版年：2015
- 出版时间：February 2015
- 年：2015
- 卷：17
- 期：2
- 全文大小：1,053 KB
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1. Leon H. Charney Division of Cardiology, New York University School of Medicine, 530 First Avenue, SKI 9R/109, New York, NY, 10016, USA - 刊物主题：Internal Medicine; Cardiology; Metabolic Diseases; Nephrology; Primary Care Medicine; General Practice / Family Medicine;
- 出版者：Springer US
- ISSN：1534-3111
文摘
Hypertension is a major modifiable risk factor for cardiovascular morbidity and mortality. Despite more than five decades of hypertension treatment, there still exist both a lack of evidence and a clear consensus to answer a fundamental question: What is the optimal blood pressure target in patients with hypertension? Early epidemiologic studies suggested the notion?of the lower the blood pressure, the better the outcomes; however, others have demonstrated a J-curve phenomenon with worse outcomes at both low and very high blood pressures. Although the existence of such a J-curve remains a topic of debate, there is now increasing recognition of target organ heterogeneity wherein the optimal blood pressure depends on the target organ in question. For cardiac protection, the current body of evidence does not support a systolic blood pressure goal of lower than 130-40?mmHg. For cerebrovascular protection, however,?lower blood pressure seems to be better with a sustained reduction in events down to a systolic blood pressure of 110-20?mmHg. The J-curve phenomenon is therefore both fact and fiction based on the target organ in question.