The diastolic J curve: alive and threatening

The occurrence of additional cardiovascular events when the diastolic blood pressure is lowered below a critical level is referred to as "the diastolic J curve." Although the critical level of diastolic blood pressure where the J curve begins is not certain, increasingly strong evidence from prospective, controlled studies has confirmed the existence of such a J curve. With the likely addition of more patients who will be treated more vigorously, in particular, elderly subjects with isolated systolic hypertension, the potential for an increase in the number of adverse cardiovascular events must be considered and caution used to avoid too low a diastolic blood pressure.