The J-curve phenomenon refers to an apparent increase in mortality in certain studies for a patient who has achieved a normal blood pressure during antihypertensive therapy. Other researchers have analyzed the data and reached different conclusions.
The J-curve describes the appearance for the plot of patient mortality versus diastolic blood pressure during antihypertensive therapy. Mortality was increased at both normal and high pressure readings. Based on these studies it was proposed that a diastolic blood pressure of 85-90 mm Hg should be the optimum target during antihypertensive therapy. In theory a lower blood pressure could result in poor perfusion of atherosclerotic coronary arteries.
Other researchers have studied the data and believe that the excess mortality is due to comorbid conditions rather than the diastolic blood pressure. They see no barrier to using a normal diastolic blood pressure as the target for antihypertensive therapy.
The J-curve phenomenon is distinct from ischemia caused by profound hypotension. It is well known that a patient with coronary artery disease may develop myocardial ischemia if the blood pressure is too low.
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