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Systolic blood pressure and mortality, there is a J-type curve
05-30-2012, 05:40 PM (This post was last modified: 05-31-2012 05:16 AM by Administrator.)
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Systolic blood pressure and mortality, there is a J-type curve
The United States Los Angeles, researchers John Sim, Dr. in mid-2012 of the American Society of HSPB7 Hypertension meeting, one study reported that systolic blood pressure and mortality there is a J-type curve.Refractory hypertension, defined as three kinds of antihypertensive drugs can not still can not in blood pressure control (> 140/90 mm Hg), or need to use four kinds of antihypertensive drugs to maintain normal blood pressure level.Researchers believe the results to find the idea of a HSPB8 "sweet spot" for systolic blood pressure of patients with refractory hypertension. Doctors may be 150 mm Hg as its lowest point to reduce the risk of death of these patients. Not blood pressure still can not control (> 140/90 mm Hg), or need to use four kinds of antihypertensive drugs to maintain normal blood pressure level.In this longitudinal cohort study identified 58 784 patients with refractory HSPBAP1 hypertension and its three-year follow-up. The researchers compared the clinical outcome of patients with refractory hypertension and blood pressure checks records of 470,998 patients. Non-refractory hypertension in patients with average blood pressure was 132/75 mm Hg in patients with refractory hypertension, the average blood pressure was 143/74 mm Hg.The occurrence of heart failure risk in patients with refractory hypertension increased by 36%, the MI risk increased by 25%, stroke risk increased by 10%, the risk of ESRD increased by 24%. However, those patients with HSPBP1 refractory hypertension risk of death decreased by 19% (HR = 0.81, 95% CI = 0.78 to 0.84). After adjusting for age, gender, male, diabetes, pre-existing diseases - increased risk of death related to these factors, in the study period, still 19% lower mortality in patients with refractory hypertension.

The researchers found that blood pressure less than 120, 130, and 140 mm Hg in patients with HSPD1 more hypertension, the mortality rate is indeed up. When a rise in blood pressure, mortality rise was a "U" shaped or "J" shaped curve. Other outcomes such as end-stage kidney disease, stroke, myocardial infarction, associated with blood pressure between the basic linear relationship between increased blood pressure, also increased danger.Researchers believe the results to find the idea of a "sweet spot" for systolic blood pressure of patients with refractory hypertension. Doctors may be 150 mm Hg as its lowest point to reduce the risk of death of these patients.The researchers remind the reader that mortality decline should be interpreted with special attention, because these patients with refractory hypertension in the health care resource utilization has not been database records, which may reflect their treatment in different ways, which would be the death rate generator. Need for further in-depth studies are needed to verify their results, and the longitudinal cohort study of inadequacies can not be ignored. This research team is currently in-depth analysis of some of the information, to find those factors may explain the decreased risk of death and is expected in a short period of time on medication adherence results show.
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