The Johns Hopkins Hospital, Baltimore, MD, 21287, USA.
Curr Atheroscler Rep. 2012 Apr;14(2):124-9. doi: 10.1007/s11883-012-0233-4.
In the era of aggressive control of cardiovascular risk factors such as hypertension, the mantra of "lower is better" has taken a strong foothold. Although there is clear epidemiologic evidence that lower blood pressure improves specific organ-related outcomes, this rule does not apply to all patients and definitely not all target organs. The concept of J-curve or adverse outcomes at lower blood pressure has been proposed for more than three decades but has recently come under increasing scrutiny. Specifically, a relationship between adverse cardiovascular outcomes and low diastolic blood pressure has been observed in multiple clinical trials. In this article we review the advances in understanding of the J-curve phenomenon and include a discussion on specific populations that might be at higher risk due to the J-curve relationship.
在积极控制心血管危险因素（如高血压）的时代，“越低越好”的口号已经深入人心。尽管有明确的流行病学证据表明降低血压可以改善与特定器官相关的结局，但这一规律并不适用于所有患者，也肯定不适用于所有目标器官。“J 型曲线”或较低血压时出现不良结局的概念已经提出了三十多年，但最近受到了越来越多的关注。具体来说，多项临床试验观察到了不良心血管结局与舒张压降低之间的关系。本文综述了对 J 型曲线现象的理解进展，并讨论了由于 J 型曲线关系而可能处于更高风险的特定人群。
