, Volume 46, Supplement 2, pp 8–15 | Cite as

Lowering Blood Pressure

How Far, How Fast?
  • Alex Roca-Cusachs


There is a general consensus that high blood pressure (BP) must be lowered gradually. A reduction in BP beyond the limits of the autoregulatory curve may compromise perfusion of vital organs, resulting in organ ischaemia. However, a reduction in high BP offers protection against cerebral events, and some protection against coronary heart disease. The limited protection against coronary heart disease provided by BP reduction may be partially explained by the so-called ‘J-shaped curve’: a reduction in diastolic blood pressure below 85mm Hg may lead to a paradoxical increase in coronary events, although this effect is by no means well established. In addition, the incidence of several events associated with cardiovascular disease peaks during morning hours, at a time when some antihypertensive drugs are least effective. This may also explain the limited coronary protection achieved after administration of antihypertensive drugs.


Coronary Heart Disease Antihypertensive Therapy Hypertensive Emergency Coronary Heart Disease Death Cerebral Event 
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Copyright information

© Adis International Limited 1993

Authors and Affiliations

  • Alex Roca-Cusachs
    • 1
  1. 1.Unidad de Hipertensión, Seryicio de Medicina InternaHospital de la Santa Creu i Sant PauBarcelonaSpain

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