The J-curve for hypertension and cardiovascular disease (CVD) describes a non-linear relationship where lowering blood pressure (BP) reduces risk, but dropping below a certain point (the nadir) increases the risk of CV events. This phenomenon is most pronounced for diastolic BP (typically <70–80 mmHg) and in patients with pre-existing coronary artery disease (CAD).
The J-curve effect describes an inverse relation between low blood pressure (BP) and cardiovascular complications. This effect is more pronounced in patients with preexisting coronary artery disease (CAD), hypertension or left ventricular hypertrophy (LVH).
Within private markets, the term “J-curve” refers to the typical pattern of returns for private equity investments –named because it resembles the letter “J.” This pattern shows initial negative returns followed by positive returns in later years, reflecting the process of investing capital and creating value.
The risk of CVD increased steadily with progressively higher levels of baseline SBP and DBP, above a usual SBP and DBP of 115 and 75 mmHg, respectively. For a 20 mmHg higher level of SBP and 10 mm Hg higher level of DBP the risk of CVD was two-fold higher (Figure 3, left-hand panel, with log-transformed vertical axis).
What is the target blood pressure for CVD patients?
Blood pressure targets in people with cardiovascular disease
Some clinical guidelines recommend a lower blood pressure goal (135/85 mmHg or lower) in people with previous heart or vascular problems compared with those without (≤140 to 160 mmHg systolic and ≤ 90 to 100 mmHg diastolic are standard blood pressure goals).
The J-curve in hypertension treatment: Fact, fable, relevance?
What are the new 2025 blood pressure guidelines?
In adults with average blood pressure ≥130/80 mm Hg and at lower 10-year cardiovascular disease risk defined by PREVENT of <7.5%, initiation of medication therapy to lower blood pressure is recommended if average blood pressure remains ≥130/80 mm Hg after an initial 3- to 6-month trial of lifestyle modification.
Normal: Less than 120 mm Hg systolic and 80 mm Hg diastolic. Elevated: 120–129 mm Hg systolic and less than 80 mm Hg diastolic. Stage 1 hypertension: 130–139 mm Hg systolic or 80–89 mm Hg diastolic. Stage 2 hypertension: 140 mm Hg or more systolic or 90 mm Hg or more diastolic.
Clogged or blocked arteries, or atherosclerosis, can lead to hypertension (high blood pressure), stroke, or even death, so it is vital to understand the signs and symptoms of blocked arteries.
Which is the main cardiovascular complication in patients with hypertension?
The most common manifestation or complication of hypertensive heart disease is cardiac arrhythmias, and the most common among these is AFib (80). AFib is an irregular and very rapid heart rhythm associated with increased risk for blood clots in the heart, stroke, and heart failure (81–84).
What best describes the relationship between blood pressure and cardiovascular disease?
The first number is called your systolic blood pressure and represents the pressure your blood exerts on your artery walls. The second number is your diastolic blood pressure which represents blood pressure against artery walls while your heart rests. As your blood pressure rises, your risk of heart disease increases.
Look no further than Japan in 2013 for a practical example of the J Curve. The country's trade balance deteriorated after a sudden depreciation in the yen, owing mostly to the fact that the volume of exports and imports took time to respond to price signals.
An example J curve. Trade starts in perfect balance, but depreciation at time 0 causes an immediate trade deficit of 50 million dollars. The balance of trade improves over time as consumers react, returning to balance at month 3 and rising to a surplus of 150 million at month 4.
The first such strategy is to invest in a company that is established and charges fees when capital is invested. In this way, an investor's capital is not charged management fees until it is put to work. The second strategy for smoothing the J-curve is to avoid acquiring businesses that need turnarounds.
The "80/40 rule" for blood pressure cuffs means the inflatable bladder inside should be about 80% of your upper arm's length and at least 40% of your upper arm's circumference for an accurate reading, preventing false high or low results by ensuring proper artery occlusion. Using a cuff that's too small (undersized) tends to overestimate blood pressure, while a cuff that's too large (oversized) can underestimate it, making correct sizing crucial for diagnosis and treatment.
Usually, blood pressure starts to rise a few hours before a person wakes up. It continues to rise during the day, peaking in midday. Blood pressure typically drops in the late afternoon and evening. Blood pressure is usually lower at night while sleeping.
What are the 4 phases of the pressure volume loop?
The ventricular function can be divided into 4 phases: isovolumic relaxation, ventricular filling, isovolumic contraction, and rapid ventricular ejection. Isovolumic relaxation is the period immediately after ventricular contraction when the aortic valve has closed, but the mitral valve has not yet opened.
High blood pressure can cause many heart conditions, including: Coronary artery disease. High blood pressure can narrow and damage the arteries that supply blood to the heart. This damage is known as coronary artery disease.
The College, in conjunction with the AHA and other national societies, recently released their updated 2025 High Blood Pressure Guideline, reaffirming a target BP of <130/80 mmHg.
An extreme spike in blood pressure, especially to 180/120 mmHg or higher, can trigger a sudden stroke. Long-term high blood pressure increases the risk of stroke.
What will a cardiologist do for high blood pressure?
“A cardiologist can do the right blood tests and put them on the right medications.” High blood pressure is the root cause of many serious health problems. It contributes to countless heart attacks, strokes and cases of heart failure each year.
When is the best time to take your blood pressure?
Take it first in the morning before eating or taking any medicine. Take it again in the evening. Each time you measure, take two or three readings to make sure your results are the same.
Wrist and finger monitors are not recommended. They give less reliable readings. Choose a monitor that has been validated. If you are unsure, ask your health care professional or pharmacist for advice or find options at validatebp.org(link opens in new window).
