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The relationship between diastolic pressure and coronary collateral circulation in patients with stable angina

Wang Shu1, Jing jing, Liu Chang Fu

  • 1The Cardiovascular Medical Department of the General Hospital of the Chinese People's Liberation Army, Beijing, China.

American Journal of Hypertension
|February 9, 2013
PubMed

Insights

High diastolic blood pressure (DBP) is linked to better coronary collateral circulation (CCC) development. This finding may explain the J-curve effect seen between DBP and cardiovascular risk.

Area of Science:

  • Cardiovascular physiology
  • Biomedical engineering

Background:

  • Coronary collateral circulation (CCC) is activated by fluid shear stress on the arterial endothelium.
  • Coronary blood flow predominantly occurs during diastole, suggesting diastolic blood pressure (DBP) influences CCC development.

Purpose of the Study:

  • To investigate the relationship between diastolic blood pressure (DBP) and the development of coronary collateral circulation (CCC).

Main Methods:

  • Studied 222 patients with stable angina and chronic total coronary occlusion.
  • Excluded patients with prior interventions, surgery, cardiomyopathy, or congenital heart disease.
  • Assessed collateral vasculature using Rentrop's classification.

Main Results:

  • High DBP and mean DBP were significantly different between patients with poorly and well-developed collaterals.
  • Multivariate analysis identified high DBP as the sole independent predictor of well-developed collateral circulation.

Conclusions:

  • Elevated DBP is positively associated with a well-developed CCC.
  • DBP's role in CCC development may contribute to the J-curve phenomenon observed in cardiovascular risk.
Abstract

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