Reverse J-curve relation between diastolic blood pressure and severity of coronary artery lesion in hypertensive patients with angina pectoris.
Reverse J-curve relation between diastolic blood pressure and severity of coronary artery lesion in hypertensive patients with angina pectoris.
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高血压心绞痛患者舒张压与冠状动脉病变严重程度之间的反向J曲线关系。
DOI：
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发表时间：
2002
影响因子：
5.4
通讯作者：
Kikuchi Kenjiro
中科院分区：
文献类型：
--
作者：
N. Hasebe;S. Kido;A. Ido;Kikuchi Kenjiro
高血压治疗中J曲线的存在仍有争议。主要的问题是，冠心病死亡率的增加是由血压（BP）降低引起的，还是由基础冠状动脉疾病的严重程度引起的。我们招募了有高血压病史（收缩压（SBP）>160 mmHg和/或舒张压（DBP）>90 mmHg）和诊断为心绞痛并经血管造影证实的冠状动脉病变的患者。观察收缩压、舒张压与冠状动脉病变程度及临床预后的关系。在234例入组患者中，115例发生了进一步事件，其中19例为严重事件。有事件和无事件的患者的平均血压无显著差异，但有事件的患者的冠状动脉严重程度指数（CSI）显著更高。作为DBP从≤ 74到≤ 105 mmHg的函数，严重事件的发生率呈正相关，CSI呈倒J曲线，最低点在95-104 mmHg。在SBP中也观察到类似的关系，但在最低SBP范围≤ 124 mmHg时提示可能存在不利结局。结论：高血压心绞痛患者的舒张压不存在J曲线，舒张压越低，预后越好。冠状动脉病变程度与舒张压呈倒J曲线关系，提示高血压在中度冠状动脉病变的高血压患者中起重要作用。
The existence of the J-curve in hypertension treatment remains controversial. The major question is whether the increase in mortality from coronary disease is induced by the lowering of blood pressure (BP) or by the severity of underlying coronary artery disease. We recruited patients with a history of hypertension (systolic BP (SBP) >160 mmHg and/or diastolic BP (DBP) >90 mmHg) and a diagnosis of angina pectoris with angiographically confirmed coronary artery lesion. The relationship among the treated levels of SBP and DBP, the severity of coronary artery lesion, and the clinical consequences were investigated. Among the 234 enrolled patients, 115 experienced further events, 19 of which were serious. There were no significant differences in the average BP of patients with and those without events, but the coronary severity indices (CSI) were significantly greater in patients with events. As a function of DBP from < or = 74 to 105 < or = mmHg, there was a positive association with the incidence of serious events, and a reversed J-curve in CSI with a nadir at 95-104 mmHg. A similar relationship was observed in SBP, but a potentially unfavorable outcome was suggested in the lowest SBP range of < or = 124 mmHg. In conclusion, there was no J-curve for DBP in hypertensive patients with angina pectoris; rather, the lower the DBP, the better was the prognosis. Interestingly, the severity of coronary lesion is in a reversed J-curve relation with DBP, suggesting that high BP plays a critical role in serious events in hypertensive patients with moderate coronary artery lesions.
影响因子：
37.8
作者：
LITTLE, WC;CONSTANTINESCU, M;SANTAMORE, WP
通讯作者：
SANTAMORE, WP
影响因子：
--
作者：
DAGOSTINO, RB;BELANGER, AJ;CRUICKSHANK, JM
通讯作者：
CRUICKSHANK, JM