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Extreme BP levels linked to elevated cardiovascular event risk in patients taking atorvastatin, results show
Tuesday, May 19 2009 | Comments
What's This?
Data from the TNT trial indicate that very low or very high blood pressure (BP) levels are associated with an increased risk for cardiovascular events, even in patients who are intensely managing their LDL cholesterol.The relationship between BP and cardiovascular events was examined in 10,001 patients with coronary artery disease who were taking either 10 mg or 80 mg of atorvastatin calcium per day. The primary composite endpoint was death from coronary disease, nonfatal myocardial infarction, resuscitation after cardiac arrest, and fatal or nonfatal stroke.
Similar to previous research, there was a J-curve relationship between BP and major cardiovascular events. More specifically, the rate of events increased if systolic BP was <130 mm Hg or >140 mm Hg and if diastolic BP was <70 mm Hg or >80 mm Hg.
The risk for major cardiovascular events was 3.1-fold higher in patients with systolic BP of <=110 mm Hg and 3.3-fold higher in patients whose diastolic BP was <=60 mm Hg.
The event rate was lowest when systolic BP was 140.6 mm Hg and diastolic BP was 79.8 mm Hg.
A J-curve was also evident for the secondary endpoints of all-cause mortality, cardiovascular mortality, nonfatal myocardial infarction, and nonfatal stroke.
"Our findings negate the dictum that with BP, lower is always better," explained Dr. Franz Messerli, co-author of the trial.
These results were presented in San Francisco at the American Society of Hypertension 24th Annual Scientific Meeting and Exposition.
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