Current Atherosclerosis Reports

, Volume 14, Issue 2, pp 124–129

The J-Point Phenomenon in Aggressive Therapy of Hypertension: New Insights

  • Gurusher S. Panjrath
  • Sameer Chaudhari
  • Franz H. Messerli
Coronary Heart Disease (J Farmer, Section Editor)

DOI: 10.1007/s11883-012-0233-4

Cite this article as:
Panjrath, G.S., Chaudhari, S. & Messerli, F.H. Curr Atheroscler Rep (2012) 14: 124. doi:10.1007/s11883-012-0233-4


In the era of aggressive control of cardiovascular risk factors such as hypertension, the mantra of “lower is better” has taken a strong foothold. Although there is clear epidemiologic evidence that lower blood pressure improves specific organ-related outcomes, this rule does not apply to all patients and definitely not all target organs. The concept of J-curve or adverse outcomes at lower blood pressure has been proposed for more than three decades but has recently come under increasing scrutiny. Specifically, a relationship between adverse cardiovascular outcomes and low diastolic blood pressure has been observed in multiple clinical trials. In this article we review the advances in understanding of the J-curve phenomenon and include a discussion on specific populations that might be at higher risk due to the J-curve relationship.


Hypertension Diastolic blood pressure Mortality Stroke Myocardial infarction Coronary artery disease 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Gurusher S. Panjrath
    • 1
  • Sameer Chaudhari
    • 2
  • Franz H. Messerli
    • 3
  1. 1.The Johns Hopkins HospitalBaltimoreUSA
  2. 2.Department of Internal MedicineGood Samaritan HospitalBaltimoreUSA
  3. 3.Division of Cardiology, St. Luke’s-Roosevelt Hospital CenterColumbia University College of Physicians and SurgeonsNew YorkUSA

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