Waits GS, et al. - The proposition explored herein was that marked lowering of diastolic blood pressure (DBP) correlated with increased risk of subclinical myocardial injury (SC-MI). It was determined that low DBP < 70 mmHg in those with SBP > 140 mmHg carried a higher risk of SC-MI, particularly in women. In order to comprehend the therapeutic implications of these findings, additional analyses were required.

Methods

• Researchers recruited 6,107 individuals without history of cardiovascular disease (CVD) from the third National Health and Nutrition Examination Survey.
• SC-MI was investigated with the aid of a validated electrocardiogram-based scoring system.
• Logistic regression assisted in analyzing the cross-sectional association between DBP (< 70, 70-80 mmHg (reference group), and > 80 mmHg; and per each 10 mmHg decrease, separately) with SC-MI across levels of systolic blood pressure (SBP) (< 120, 120-139, or > 140 mmHg).

Results

• The multivariable model illustrated the correlation between DBP < 70 mmHg with a higher risk of SC-MI [OR (95% CI) 1.40 (1.02, 1.94)] in enrollees with SBP > 140 mmHg.
• This connection was discovered to be consistent in subgroups stratified by age, race, diabetes, hypertension, obesity and smoking, but was stronger in women than in men [OR (95% CI) 1.58 (1.06, 2.37) vs. 1.10 (0.62, 1.94), respectively; interaction p value=0.006].
• Every 10 mmHg decrease in DBP exhibited a link with a 12% increased odds of SC-MI [OR (95% CI) 1.12 (1.01, 1.23)], among participants with SBP > 140 mmHg.
• The findings did not disclose any prominent correlations between DBP and SC-MI, in those with SBP < 120 mmHg or 120-139 mmHg, or between DBP > 80 mmHg and SC-MI in any of SBP levels.