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Low Diastolic Pressure Linked to Subclinical Myocardial Damage

High-sensitivity cardiac troponin-T more likely among those with DBP below 60 or 60 to 69 mm Hg

THURSDAY, Oct. 13, 2016 (HealthDay News) — Low diastolic blood pressure (DBP) seems to be associated with subclinical myocardial damage, according to a study published in the Oct. 18 issue of the Journal of the American College of Cardiology.

John W. McEvoy, M.B., B.Ch., from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues studied 11,565 adults from the Atherosclerosis Risk in Communities (ARIC) cohort to examine the independent association of DBP with myocardial damage (using high-sensitivity cardiac troponin-T [hs-cTnT]).

The researchers found that the adjusted odds ratio of having hs-cTnT ≥14 ng/l at ARIC visit 2 (baseline) was 2.2 and 1.5 for those with DBP <60 mm Hg and 60 to 69 mm Hg, respectively, compared with those with DBP of 80 to 89 mm Hg at baseline. There was also an independent association for low DBP at baseline with progressive myocardial damage on the basis of estimated annual change in hs-cTnT between ARIC visits 2 and 4 (six years). Having a DBP of <60 mm Hg versus 80 to 89 mm Hg correlated with incident coronary heart disease (CHD) and mortality but not with stroke. Patients with baseline systolic blood pressure (SBP) ≥120 mm Hg had the most pronounced associations of low DBP with prevalent hs-cTnT and incident CHD.

“When titrating treatment to SBP <140 mm Hg, it may be prudent to ensure that DBP levels do not fall below 70 mm Hg, and particularly not below 60 mm Hg,” the authors write.

Several authors disclosed ties to pharmaceutical companies, including Roche Diagnostics, which provided reagents for the cardiac troponin assays.

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