The J-curve between Diastolic Blood Pressure and Risk of All-cause and Cardiovascular Death
Open Access
- 1 January 2018
- journal article
- research article
- Published by The Korean Society of Cardiology in Korean Circulation Journal
- Vol. 48 (1), 36-47
- https://doi.org/10.4070/kcj.2017.0036
Abstract
Background and objectives: The J-curve phenomenon between diastolic blood pressure (DBP) and mortality has been reported repeatedly in treated patients. However, the baseline risk of low DBP has not been fully explored. This study was to examine the relationship between DBP and risk of mortality from all-cause, atherosclerotic vascular diseases (ASCVD), and ischemic heart disease (IHD) using a prospective cohort of general population.& para;& para;Methods: We analyzed 1,234,435 participants of the Korean Cancer Prevention Study cohort (789,255 men, 30-95 years of age) who had a medical evaluation from 1992 to 1995 using Cox proportional hazards models.& para;& para;Results: A total of 22.5 million person-years were followed up (mean age 46.6 years, deaths 193,903 cases). The hazard ratios of mortality from all-cause and ASCVD, among those with DBP = 60 years of age, smoker or non-smoker and diabetes mellitus (DM) or non-DM subgroups. The risk in DBP 60-69 mmHg groups increased in several subgroups. However, the risk for ASCVD death in 30-59 years and DM group, and risk for IHD death in most subgroups except for elderly (>= 60 years) decreased.& para;& para;Conclusion: A J-curve relationship between low DBP and all-cause death was found consistently. The baseline risk in the general population may be considered for risk assessment, particularly in case of interventions that lower DBP below 60 mmHg.Keywords
Funding Information
- Korean Society of Cardiology (201203-10)
This publication has 30 references indexed in Scilit:
- Trends in the Incidence of Hospitalized Acute Myocardial Infarction and Stroke in Korea, 2006-2010Journal of Korean Medical Science, 2013
- Cardiovascular disease risk factors in relation to suicide mortality in Asia: prospective cohort study of over one million Korean men and womenEuropean Heart Journal, 2011
- Target Blood Pressure for Treatment of Isolated Systolic Hypertension in the ElderlyHypertension, 2010
- Body Mass Index and Stroke Mortality by Smoking and Age at Menopause Among Korean Postmenopausal WomenStroke, 2009
- Single Versus Combined Blood Pressure Components and Risk for Cardiovascular DiseaseCirculation, 2009
- Principal Results of the Japanese Trial to Assess Optimal Systolic Blood Pressure in Elderly Hypertensive Patients (JATOS)Hypertension Research, 2008
- Ambulatory Blood Pressure and 10-Year Risk of Cardiovascular and Noncardiovascular MortalityHypertension, 2005
- Cigarette Smoking, Alcohol Drinking, Hepatitis B, and Risk for Hepatocellular Carcinoma in KoreaJNCI Journal of the National Cancer Institute, 2004
- Blood pressure and cardiovascular disease in the Asia Pacific regionJournal Of Hypertension, 2003