Rahman F, et al. – Researchers presumed that the J–curve would be most pronounced among persons with coronary artery calcium. In this current study, a link was shown between diastolic blood pressure <60 mmHg and increased risk of coronary heart disease events and all–cause mortality, respectively, in the sample overall. In addition, this link appeared to be strongest among individuals with subclinical atherosclerosis.

Methods

• Among 6,811 participants from the Multi-Ethnic Study of Atherosclerosis, researchers used Cox models to assess if diastolic blood pressure category is related to coronary heart disease events, stroke, and mortality.
• They conducted analyses in the sample overall and after stratification by coronary artery calcium score.

Results

• Findings demonstrated that, in multivariable-adjusted analyses, compared with diastolic blood pressure of 80 to 89 mmHg (reference), persons with diastolic blood pressure <60 mmHg had increased risk of coronary heart disease events (hazard ratio 1.69 [95% confidence interval 1.02-2.79]) and all-cause mortality (hazard ratio 1.48 [95% confidence interval 1.10-2.00]), but not stroke.
• Researchers observed that after stratification, associations of diastolic blood pressure <60 mmHg with events were present only among participants with coronary artery calcium >0.
• They also noted that diastolic blood pressure <60 mmHg was not associated with events when coronary artery calcium was zero.
• As per data, the association between diastolic blood pressure and events did not demonstrate statistical interaction when stratified by presence or absence of coronary calcium.
• Results highlighted no interaction in the association between low diastolic blood pressure and events based on race.