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Low blood pressure is a risk for coronary heart disease suffers

Reducing diastolic blood pressure below

a critical low point may be associated with excess mortality and morbidity in patients with coronary artery disease, reveals an analysis published by the Ann Intern Med.

The researchers concluded that excessive reduction in diastolic pressure should be avoided in patients with coronary artery disease.

Researchers examined 22,576 patients with hypertension and coronary artery disease in 862 sites across 14 countries. Researchers found a J-shaped association between diastolic blood pressure and risk for the primary outcome (all-cause death, non-fatal stroke and non-fatal myocardial infarction), all-cause death and total MI with a blood pressure nadir at 119/84mmHg.

The MI-to-stroke ratio remained constant over a wide blood pressure range, but at a lower diastolic blood pressure there were substantially more myocardial infarctions than strokes.

Reference

Messerli F, Mancia G et al. Dogma disputed: Can aggressively lowering blood pressure in hypertensive patients with coronary artery disease be dangerous? Ann Intern Med 2006:144;884–93

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