The J-curve. Myth and reality. Hypotensive treatment strategy considerations

Abstract

Hypertension is one of the main cardiovascular risk factors and according to WHO is the cause of at least 7.1 million early deaths in the world. One of the mechanisms responsible for such an unfavorable prognosis is arterial remodeling caused by hypertension. The results of the studies analyzing relationship between blood pressure values, carotid artery wall thickness and progression of carotid atherosclerosis, as well as the relation between IMT (intima media thickness) value and the cardiovascular risk caused an inclusion of an IMT measurements into the panel of tests describing target organ damage in hypertensive patients (recommendation of the European Society of Hypertension and European Society of Cardiology). In order to make the measurement of IMT a common diagnostic tool in the risk stratification of unfavorable cardiovascular events, it seems to be important to standardize the methodology i.e. the measuring methods (location and number of measurements) and the images analysis (manual and automatic method).