The J-curve relationship between diastolic pressure and coronary collateral circulation in patients with single chronic total occlusion

Abstract

Background: In our previous study, we had shown that high diastolic blood pressure (DBP) was positively related to well-developed coronary collateral circulation (CCC). This study sought to find out the more precise relationship between DBP and CCC.

Methods and results: To investigate this, we conducted a study of 671 patients with single chronic total occlusion of coronary artery. The DBP of the patients was divided into six groups: ≤ 65 mmHg, >65-≤ 75 mmHg, >75-≤ 85 mmHg, >85-≤ 95 mmHg, >95-≤ 105 mmHg, >105 mmHg). The extent of CCC was graded as poorly-developed or well-developed collaterals according to Rentrop classification. There was a J-curve relationship between the level of DBP and the incidence of poorly-developed collaterals.

Conclusion: The relationship between DBP and CCC is similar to the J-curve relationship between DBP and cardiovascular risk. The influence of DBP on the development of CCC may be one of the pathophysiologic mechanisms of the J-curve phenomenon relating DBP to cardiovascular risk.

Keywords: Coronary collateral circulation; Diastolic blood pressure; J-curve phenomenon.