Return of the J-curve: TNT analysis shows that BP can be too low in CAD patients

Return of the J-curve: TNT analysis shows that BP can be too low in CAD patients

May 8, 2009 | Michael O'Riordan

San Francisco, CA - An analysis of one of the major "lower-is-better" cholesterol trials has shown that lower might not be best when it comes to blood pressure. In fact, in this group of patients with coronary artery disease, despite substantial lowering of LDL-cholesterol levels, a J-curve relationship exists between systolic and diastolic blood pressure and cardiovascular events.

"It stands to reason that when you lower blood pressure too much, you can do harm," said study investigator Dr Franz Messerli (St Luke's-Roosevelt Hospital, New York). "After all, if blood pressure is zero, mortality is 100%. So somewhere there must be a nadir, below which the lowering of blood pressure becomes counterproductive."

The findings, from an analysis of the Treating to New Targets (TNT) study, were presented here yesterday at the American Society of Hypertension 2009 Scientific Meeting in San Francisco, CA./.../