Low Diastolic BP Linked to Adverse Cardiac Outcomes
HealthDay News — Low diastolic blood pressure (DBP) seems to be associated with subclinical myocardial damage, according to a study published in the October 18 issue of the Journal of the American College of Cardiology.
John W. McEvoy, MB, BCh, from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues studied 11,565 adults from the Atherosclerosis Risk in Communities (ARIC) cohort to examine the independent association of DBP with myocardial damage (using high-sensitivity cardiac troponin-T [hs-cTnT]).
The researchers found that the adjusted odds ratio of having hs-cTnT ≥14 ng/l at ARIC visit 2 (baseline) was 2.2 and 1.5 for those with DBP <60mmHg and 60 to 69mmHg, respectively, compared with those with DBP of 80 to 89mmHg at baseline. There was also an independent association for low DBP at baseline with progressive myocardial damage on the basis of estimated annual change in hs-cTnT between ARIC visits 2 and 4 (six years). Having a DBP of <60mmHg versus 80 to 89mmHg correlated with incident coronary heart disease (CHD) and mortality but not with stroke. Patients with baseline systolic blood pressure (SBP) ≥120 mm Hg had the most pronounced associations of low DBP with prevalent hs-cTnT and incident CHD.
"When titrating treatment to SBP <140mmHg, it may be prudent to ensure that DBP levels do not fall below 70mmHg, and particularly not below 60mmHg," the authors write.
Several authors disclosed ties to pharmaceutical companies, including Roche Diagnostics, which provided reagents for the cardiac troponin assays.