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Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
04:37

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension

Published on: June 6, 2025

Current status of aggressive blood pressure control

Steven G Chrysant1

  • 1Steven G Chrysant, Oklahoma Cardiovascular and Hypertension Center, Oklahoma City, OK 73132, United States.

World Journal of Cardiology
|April 19, 2011
PubMed

Insights

Aggressive blood pressure control may harm patients, as low diastolic pressure is linked to cardiovascular events (J-curve effect). The heart is vulnerable to these fluctuations, especially with existing heart conditions.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Hypertension treatment has evolved significantly, from neglect to aggressive control.
  • Recent evidence suggests overly aggressive blood pressure reduction may be detrimental.
  • The J-curve effect, where low diastolic blood pressure increases cardiovascular risk, is a growing concern.

Purpose of the Study:

  • To review the current understanding of the J-curve effect in hypertension management.
  • To explore the association between low blood pressure levels and cardiovascular events.
  • To discuss the differential impact of blood pressure fluctuations on the heart and brain.

Main Methods:

  • A Medline literature search was conducted from 1992 to 2010.
  • Eleven pertinent articles were selected for review.
  • Collateral literature was also included for a comprehensive discussion.

Main Results:

  • Low diastolic blood pressure is associated with increased cardiovascular events (J-curve effect).
  • The heart's vulnerability to diastolic blood pressure fluctuations is exacerbated by coronary heart disease and left ventricular hypertrophy.
  • The J-curve effect has also been observed with systolic blood pressure, though less frequently than with diastolic pressure.

Conclusions:

  • Aggressive blood pressure control may not always be beneficial and can be associated with adverse cardiovascular outcomes.
  • Understanding the J-curve effect is crucial for optimizing hypertension treatment strategies.
  • The autoregulation mechanisms of the brain differ from the heart, influencing their susceptibility to blood pressure variations.

Keywords:
Coronary heart diseaseHypertensionJ-curveStrokeTreatment

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