Coope J
Waterhouse, Bollington, Macclesfield, UK.
J Hum Hypertens. 1990 Feb;4(1):1-4.
Many studies have established that mortality from heart attacks is related to diastolic blood pressure in a J-curve with increased mortality at low as well as high pressures. This has been observed in untreated as well as treated patients and a similar phenomenon has been found in large population studies. Two hypotheses to account for this curve have been advanced. The direct causation hypothesis attributes the increased mortality at low pressures to low coronary perfusion. The reverse causation hypothesis attributes the curve to a subgroup of patients with low blood pressures as a result of pre-existing disease. This controversy is still unresolved and needs a prospective trial to decide the issue.
许多研究已经证实，心脏病发作导致的死亡率与舒张压呈J形曲线关系，即低压和高压时死亡率都会增加。这在未治疗和已治疗的患者中均有观察到，并且在大规模人群研究中也发现了类似现象。针对这种曲线，人们提出了两种假说。直接因果关系假说认为，低压时死亡率增加是由于冠状动脉灌注不足。反向因果关系假说则认为，该曲线是由先前存在疾病导致血压低的患者亚组造成的。这一争议仍未解决，需要进行前瞻性试验来确定这个问题。
