TY - JOUR
T1 - Association of low diastolic blood pressure with cardiovascular outcomes and all-cause mortality
T2 - A meta-analysis
AU - Siddiqi, Tariq Jamal
AU - Usman, Muhammad Shariq
AU - Siddiqui, Amna
AU - Salman, Ali
AU - Talbot, Nicholas
AU - Khan, Laibah Arshad
AU - Shabbir, Aisha
AU - Hall, Michael E.
AU - Taffet, George E.
N1 - Funding Information:
The authors affirm the work submitted is original and that all statements declared as facts are based on thorough examination and investigation for accuracy. None.
Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2024/1
Y1 - 2024/1
N2 - BACKGROUND: Reduction of diastolic blood pressure (DBP) below 70 mmHg may decrease perfusion to the heart and worsen cardiovascular (CV) outcomes.AIMS: Explore the association between low DBP and CV outcomes.METHODS: We searched the online databases until August 2023 for studies reporting the risk of all-cause mortality (ACM) or CV outcomes in patients with low versus normal DBP (70-80mm Hg).RESULTS: Inclusion of 10 studies (n = 1,998,223 patients) found that a mean achieved DBP < 60 mmHg was associated with an increased risk of all-cause mortality (HR 1.48; 95 % CI [1.26-1.74]), especially in patients with pre-existing CV disease. It was also associated to a higher risk of major adverse cardiovascular events (HR 1.84; [1.28-2.65]) and myocardial infarction (HR 1.49; [1.13-1.97]). A DBP of 60-69 mmHg was associated with an increased risk of all-cause mortality (HR 1.11; [1.03-1.20]).CONCLUSION: Reduction of DBP, particularly below 60 mmHg, is associated with increased risk of ACM.
AB - BACKGROUND: Reduction of diastolic blood pressure (DBP) below 70 mmHg may decrease perfusion to the heart and worsen cardiovascular (CV) outcomes.AIMS: Explore the association between low DBP and CV outcomes.METHODS: We searched the online databases until August 2023 for studies reporting the risk of all-cause mortality (ACM) or CV outcomes in patients with low versus normal DBP (70-80mm Hg).RESULTS: Inclusion of 10 studies (n = 1,998,223 patients) found that a mean achieved DBP < 60 mmHg was associated with an increased risk of all-cause mortality (HR 1.48; 95 % CI [1.26-1.74]), especially in patients with pre-existing CV disease. It was also associated to a higher risk of major adverse cardiovascular events (HR 1.84; [1.28-2.65]) and myocardial infarction (HR 1.49; [1.13-1.97]). A DBP of 60-69 mmHg was associated with an increased risk of all-cause mortality (HR 1.11; [1.03-1.20]).CONCLUSION: Reduction of DBP, particularly below 60 mmHg, is associated with increased risk of ACM.
KW - All-cause mortality
KW - Diastolic blood pressure
KW - Ischemic stroke
KW - Major adverse Cardiovascular events
KW - Myocardial infarction
KW - Blood Pressure/physiology
KW - Myocardial Infarction/etiology
KW - Humans
KW - Cardiovascular Diseases/epidemiology
KW - Hypertension/complications
KW - Heart Failure/complications
KW - Stroke/etiology
UR - http://www.scopus.com/inward/record.url?scp=85178315971&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85178315971&partnerID=8YFLogxK
U2 - 10.1016/j.cpcardiol.2023.102131
DO - 10.1016/j.cpcardiol.2023.102131
M3 - Review article
C2 - 37866417
AN - SCOPUS:85178315971
SN - 0146-2806
VL - 49
SP - 102131
JO - Current Problems in Cardiology
JF - Current Problems in Cardiology
IS - 1 Pt C
M1 - 102131
ER -