{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T04:40:31Z","timestamp":1766983231295,"version":"3.37.3"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2018,12,16]],"date-time":"2018-12-16T00:00:00Z","timestamp":1544918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>The threshold of blood pressure (BP) reduction in cardiovascular patients is debatable due to the J-shaped curve phenomenon, which is particularly observed in patients with increased arterial stiffness. The renal resistive index (RRI) correlates well with systemic arterial stiffness; therefore, we aimed to demonstrate the role of RRI in guiding the choice of optimal BP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A retrospective analysis of prospectively collected data of the hospitalized cardiovascular patients at Jichi Medical University Hospital. All patients had the RRI measurement performed and were assigned to a higher (RRI \u2265 0.8) or lower RRI group. Each group was subdivided by quartiles of the BP at discharge. The primary endpoints were fatal and nonfatal cardiovascular events, including heart failure, acute coronary syndrome, acute aortic disease, acute arterial occlusion, and stroke.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The mean follow-up period was 1.9 years (3,365 person-years), n = 1,777 (mean age 64.7 years). There were 252 cardiovascular events occurred, 24.0% and 12.2% in the higher and lower RRI populations, P &amp;lt; 0.001. In the higher RRI group, the lowest systolic BP (SBP) quartile (&amp;lt;105 mm Hg) was a risk factor for cardiovascular events when compared with the highest SBP quartile (\u2265130 mm Hg; adjusted hazard ratio, 2.42; 95% confidence interval, 1.17\u20135.03; P = 0.017). A 1 SD decrease of SBP (17.5 mm Hg) was associated with a 25% increase in the risk of cardiovascular events. In the lower RRI group, these associations were not observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Lower SBP at discharge was associated with a risk of cardiovascular events in the hospitalized cardiovascular patients with RRI \u2265 0.8.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpy189","type":"journal-article","created":{"date-parts":[[2018,12,13]],"date-time":"2018-12-13T22:52:07Z","timestamp":1544741527000},"page":"365-374","source":"Crossref","is-referenced-by-count":3,"title":["Lower Systolic Blood Pressure and Cardiovascular Event Risk Stratified by Renal Resistive Index in Hospitalized Cardiovascular Patients: J-VAS Study"],"prefix":"10.1093","volume":"32","author":[{"given":"Praew","family":"Kotruchin","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, School of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan"},{"name":"Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7541-5751","authenticated-orcid":false,"given":"Satoshi","family":"Hoshide","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, School of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromi","family":"Ueno","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, School of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Komori","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, School of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8251-4480","authenticated-orcid":false,"given":"Kazuomi","family":"Kario","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, School of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2018,12,16]]},"reference":[{"key":"2022111018425183500_CIT0001","doi-asserted-by":"crossref","first-page":"e127","DOI":"10.1016\/j.jacc.2017.11.006","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"71","author":"Whelton","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2022111018425183500_CIT0002","doi-asserted-by":"crossref","first-page":"2103","DOI":"10.1056\/NEJMoa1511939","article-title":"A randomized trial of intensive versus standard blood-pressure control","volume":"373","author":"Wright","year":"2015","journal-title":"N Engl J Med"},{"key":"2022111018425183500_CIT0003","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1161\/HYPERTENSIONAHA.117.10177","article-title":"Effect of lowering diastolic pressure in patients with and without cardiovascular disease: analysis of the SPRINT (Systolic Blood Pressure Intervention Trial)","volume":"71","author":"Khan","year":"2018","journal-title":"Hypertension"},{"key":"2022111018425183500_CIT0004","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.amjcard.2004.04.043","article-title":"A likely explanation for the J-curve of blood pressure cardiovascular risk","volume":"94","author":"Kannel","year":"2004","journal-title":"Am J Cardiol"},{"key":"2022111018425183500_CIT0005","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1016\/S0140-6736(98)04311-6","article-title":"Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. 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