Mechanisms underlying the J-curve for diastolic blood pressure: Subclinical myocardial injury and immune activation.

ABSTRACT: BACKGROUND:Low 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. METHODS:We 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. RESULTS:After adjusting for demographic and clinical covariates, individuals with DBP?

SUBMITTER: Topel ML 

PROVIDER: S-EPMC6324952 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature