The J-curve Phenomenon In The Treatment Of Hypertension And Individual Therapy Of Traditional Chinese Medicine

Objective：Through retrospective systematic review of the relationship of cardiova-scular events’morbidity，mortality and the blood pressure level，to provide relative EBMevidences for the clinical decision of treating hypertension by TCM.Methods: To adopt EBM systematic review and meta-analysis.Using PUBMEDdata base to search medical literatures of hypertension EBM from the year1950to2010.Using RevMan4.1to make a meta-analysis of the relative data which are searched，and also make heterogeneity analysis and sensitivity analysis，and using funnel plot toanalyse publication bias.We make reorganization induction and refine analysis on theliteratures which have no detail data.Results:Total893relative medical literatures had been searched out. We adopt28high quality literatures for our study according to literature inclusion criteria，which are allcarried on in foreign counties，and all of them have explicit and general recognizedstandard of diagnosis and efficacy judgment. We made meta-analysis on8literatures thathave detail data. The results of meta-analysis reveal that for the blood pressure it is not thelower the better，the results are steady，but the funnel plot reveals that they may havepublication bias.Through comprehensive analysis on the surplus20literatures， weconjecture that there is a J-curve relationship between the morbidity and mortality ofcardiovascular events and the diastolic pressure.Conclusion: The mortality of cardiovascular events are not in proportion to thereduction of diastolic pressure，we conjecture that there is a J-curve phenomenon betweenthe morbidity and mortality of cardiovascular events and the diastolic pressure.The level of blood pressure has no J-curve relationship with apoplexy or complications of other targetorgans. We did not find any J-curve relationship between systolic pressure and coronaryartery，kidney or cerebrovascular events.