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What is the J-curve?

Posted by anna_mae on May 18, 1999 at 11:40:56
My 75 year mother has had high blood pressure for the past 25 years or so. She developed diabetes 5 years ago and is on diet therapy. Her Fasting sugar varies in a range from 7 to 9 mmols. We were told she may have coronary artey disease. However, she has no symptoms. Stress test was inconclusive and we were not keen on angiogram. 3 months ago her cardio found her BP to be 160/80. He  increased the dose of her blood pressure medication. Now, her BP readings are between 135-145 (systolic) and 60-65 diastolic. A doctor we consulted for some other problem told me the BP may be too low. He mentioned something about a "J-curve" and that possible harm may come if blood pressures are too low. It could lead to a heart attack or stroke. This he said, may happen if the diastolic BP goes too low. Is this true?  Could someone enlighten me on this "J-curve"? Is my mother's BP too low? Should the dose of her BP medication be reduced?

Posted by CCF CARDIO MD - MTR on May 18, 1999 at 19:19:23
Dear Anna Mae, thank you for your question.  I don't know what the physician you mention was referring to with the "J-curve."  I think your mother's BP sounds well controlled now and a diastolic BP of 60-65 should be fine.  However, I cannot give specific medical advice to you, so I suggest that you speak with her original cardiologist and let that physician manage her BP medications rather than the new physician who referred to the "J-curve."
I hope you find this information useful.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your physician.   Please don't hesitate to write back if you have further questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-223-2273 and ask for cardiology appointments.  Alternatively, you can inquire online at www.ccf.org/heartcenter where you can make an appointment with a specific staff cardiologist or browse the site for more information about the Heart Center.

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