Association of low diastolic blood pressure with cardiovascular outcomes and all-cause mortality: A meta-analysis

Tariq Jamal Siddiqi; Muhammad Shariq Usman; Amna Siddiqui; Ali Salman; Nicholas Talbot; Laibah Arshad Khan; Aisha Shabbir; Michael E. Hall; George E. Taffet

doi:10.1016/j.cpcardiol.2023.102131

Association of low diastolic blood pressure with cardiovascular outcomes and all-cause mortality: A meta-analysis

Tariq Jamal Siddiqi, Muhammad Shariq Usman, Amna Siddiqui, Ali Salman, Nicholas Talbot, Laibah Arshad Khan, Aisha Shabbir, Michael E. Hall, George E. Taffet

Research output: Contribution to journal › Review article › peer-review

16 Scopus citations

Abstract

BACKGROUND: Reduction of diastolic blood pressure (DBP) below 70 mmHg may decrease perfusion to the heart and worsen cardiovascular (CV) outcomes.

AIMS: Explore the association between low DBP and CV outcomes.

METHODS: We searched the online databases until August 2023 for studies reporting the risk of all-cause mortality (ACM) or CV outcomes in patients with low versus normal DBP (70-80mm Hg).

RESULTS: Inclusion of 10 studies (n = 1,998,223 patients) found that a mean achieved DBP < 60 mmHg was associated with an increased risk of all-cause mortality (HR 1.48; 95 % CI [1.26-1.74]), especially in patients with pre-existing CV disease. It was also associated to a higher risk of major adverse cardiovascular events (HR 1.84; [1.28-2.65]) and myocardial infarction (HR 1.49; [1.13-1.97]). A DBP of 60-69 mmHg was associated with an increased risk of all-cause mortality (HR 1.11; [1.03-1.20]).

CONCLUSION: Reduction of DBP, particularly below 60 mmHg, is associated with increased risk of ACM.

Original language	English (US)
Article number	102131
Pages (from-to)	102131
Journal	Current Problems in Cardiology
Volume	49
Issue number	1 Pt C
DOIs	https://doi.org/10.1016/j.cpcardiol.2023.102131
State	Published - Jan 2024

Keywords

All-cause mortality
Diastolic blood pressure
Ischemic stroke
Major adverse Cardiovascular events
Myocardial infarction
Blood Pressure/physiology
Myocardial Infarction/etiology
Humans
Cardiovascular Diseases/epidemiology
Hypertension/complications
Heart Failure/complications
Stroke/etiology

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

Divisions

Geriatrics

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10.1016/j.cpcardiol.2023.102131

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@article{5f5ba9fab6704e4db79eb0ae1ca08ee7,

title = "Association of low diastolic blood pressure with cardiovascular outcomes and all-cause mortality: A meta-analysis",

abstract = "BACKGROUND: Reduction of diastolic blood pressure (DBP) below 70 mmHg may decrease perfusion to the heart and worsen cardiovascular (CV) outcomes.AIMS: Explore the association between low DBP and CV outcomes.METHODS: We searched the online databases until August 2023 for studies reporting the risk of all-cause mortality (ACM) or CV outcomes in patients with low versus normal DBP (70-80mm Hg).RESULTS: Inclusion of 10 studies (n = 1,998,223 patients) found that a mean achieved DBP < 60 mmHg was associated with an increased risk of all-cause mortality (HR 1.48; 95 \% CI [1.26-1.74]), especially in patients with pre-existing CV disease. It was also associated to a higher risk of major adverse cardiovascular events (HR 1.84; [1.28-2.65]) and myocardial infarction (HR 1.49; [1.13-1.97]). A DBP of 60-69 mmHg was associated with an increased risk of all-cause mortality (HR 1.11; [1.03-1.20]).CONCLUSION: Reduction of DBP, particularly below 60 mmHg, is associated with increased risk of ACM.",

keywords = "All-cause mortality, Diastolic blood pressure, Ischemic stroke, Major adverse Cardiovascular events, Myocardial infarction, Blood Pressure/physiology, Myocardial Infarction/etiology, Humans, Cardiovascular Diseases/epidemiology, Hypertension/complications, Heart Failure/complications, Stroke/etiology",

author = "Siddiqi, \{Tariq Jamal\} and Usman, \{Muhammad Shariq\} and Amna Siddiqui and Ali Salman and Nicholas Talbot and Khan, \{Laibah Arshad\} and Aisha Shabbir and Hall, \{Michael E.\} and Taffet, \{George E.\}",

note = "Funding Information: The authors affirm the work submitted is original and that all statements declared as facts are based on thorough examination and investigation for accuracy. None. Publisher Copyright: {\textcopyright} 2023 Elsevier Inc.",

year = "2024",

month = jan,

doi = "10.1016/j.cpcardiol.2023.102131",

language = "English (US)",

volume = "49",

pages = "102131",

journal = "Current Problems in Cardiology",

issn = "0146-2806",

publisher = "Elsevier",

number = "1 Pt C",

}

TY - JOUR

T1 - Association of low diastolic blood pressure with cardiovascular outcomes and all-cause mortality

T2 - A meta-analysis

AU - Siddiqi, Tariq Jamal

AU - Usman, Muhammad Shariq

AU - Siddiqui, Amna

AU - Salman, Ali

AU - Talbot, Nicholas

AU - Khan, Laibah Arshad

AU - Shabbir, Aisha

AU - Hall, Michael E.

AU - Taffet, George E.

N1 - Funding Information: The authors affirm the work submitted is original and that all statements declared as facts are based on thorough examination and investigation for accuracy. None. Publisher Copyright: © 2023 Elsevier Inc.

PY - 2024/1

Y1 - 2024/1

N2 - BACKGROUND: Reduction of diastolic blood pressure (DBP) below 70 mmHg may decrease perfusion to the heart and worsen cardiovascular (CV) outcomes.AIMS: Explore the association between low DBP and CV outcomes.METHODS: We searched the online databases until August 2023 for studies reporting the risk of all-cause mortality (ACM) or CV outcomes in patients with low versus normal DBP (70-80mm Hg).RESULTS: Inclusion of 10 studies (n = 1,998,223 patients) found that a mean achieved DBP < 60 mmHg was associated with an increased risk of all-cause mortality (HR 1.48; 95 % CI [1.26-1.74]), especially in patients with pre-existing CV disease. It was also associated to a higher risk of major adverse cardiovascular events (HR 1.84; [1.28-2.65]) and myocardial infarction (HR 1.49; [1.13-1.97]). A DBP of 60-69 mmHg was associated with an increased risk of all-cause mortality (HR 1.11; [1.03-1.20]).CONCLUSION: Reduction of DBP, particularly below 60 mmHg, is associated with increased risk of ACM.

AB - BACKGROUND: Reduction of diastolic blood pressure (DBP) below 70 mmHg may decrease perfusion to the heart and worsen cardiovascular (CV) outcomes.AIMS: Explore the association between low DBP and CV outcomes.METHODS: We searched the online databases until August 2023 for studies reporting the risk of all-cause mortality (ACM) or CV outcomes in patients with low versus normal DBP (70-80mm Hg).RESULTS: Inclusion of 10 studies (n = 1,998,223 patients) found that a mean achieved DBP < 60 mmHg was associated with an increased risk of all-cause mortality (HR 1.48; 95 % CI [1.26-1.74]), especially in patients with pre-existing CV disease. It was also associated to a higher risk of major adverse cardiovascular events (HR 1.84; [1.28-2.65]) and myocardial infarction (HR 1.49; [1.13-1.97]). A DBP of 60-69 mmHg was associated with an increased risk of all-cause mortality (HR 1.11; [1.03-1.20]).CONCLUSION: Reduction of DBP, particularly below 60 mmHg, is associated with increased risk of ACM.

KW - All-cause mortality

KW - Diastolic blood pressure

KW - Ischemic stroke

KW - Major adverse Cardiovascular events

KW - Myocardial infarction

KW - Blood Pressure/physiology

KW - Myocardial Infarction/etiology

KW - Humans

KW - Cardiovascular Diseases/epidemiology

KW - Hypertension/complications

KW - Heart Failure/complications

KW - Stroke/etiology

UR - https://www.scopus.com/pages/publications/85178315971

UR - https://www.scopus.com/inward/citedby.url?scp=85178315971&partnerID=8YFLogxK

U2 - 10.1016/j.cpcardiol.2023.102131

DO - 10.1016/j.cpcardiol.2023.102131

M3 - Review article

C2 - 37866417

AN - SCOPUS:85178315971

SN - 0146-2806

VL - 49

SP - 102131

JO - Current Problems in Cardiology

JF - Current Problems in Cardiology

IS - 1 Pt C

M1 - 102131

ER -

Association of low diastolic blood pressure with cardiovascular outcomes and all-cause mortality: A meta-analysis

Abstract

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