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Long-Term Systolic Blood Pressure Time in Target Range and Cardiovascular Disease in Individuals With Hypertension

Huo, Zhenyu ; Wu, Shouling ; Li, Liuxin ; Zhang, Jingdi ; Liu, Yang ; Han, Xu ; Chen, Shuohua ; Wang, Guodong ; Li, Yun and Zhang, Shunming LU , et al. (2025) In JACC: Advances
Abstract

BACKGROUND: Previous post hoc analyses of clinical trials have suggested that a higher percentage of systolic blood pressure time in target range (SBP-TTR) was associated with a decreased risk of cardiovascular disease (CVD). However, there is limited evidence from large prospective cohort studies on the relationship between long-term SBP-TTR and the risk of CVD.

OBJECTIVES: The purpose of this study was to assess the association between long-term SBP-TTR and the risk of CVD in adults with hypertension.

METHODS: This study included 26,929 hypertensive patients (mean age 52.8 ± 10.7 years; 83.1% males), free of CVD at baseline from the Kailuan Study. Blood pressure was measured biennially from 2006 to 2012, and the SBP target... (More)

BACKGROUND: Previous post hoc analyses of clinical trials have suggested that a higher percentage of systolic blood pressure time in target range (SBP-TTR) was associated with a decreased risk of cardiovascular disease (CVD). However, there is limited evidence from large prospective cohort studies on the relationship between long-term SBP-TTR and the risk of CVD.

OBJECTIVES: The purpose of this study was to assess the association between long-term SBP-TTR and the risk of CVD in adults with hypertension.

METHODS: This study included 26,929 hypertensive patients (mean age 52.8 ± 10.7 years; 83.1% males), free of CVD at baseline from the Kailuan Study. Blood pressure was measured biennially from 2006 to 2012, and the SBP target range was defined as 120 to 140 mm Hg. SBP-TTR was calculated by the Rosendaal linear interpolation method. Incident CVD events were ascertained via the linkage of electronic health record data.

RESULTS: During a median follow-up of 8.6 years, 2,565 CVD, including 472 myocardial infarction and 2,151 stroke cases were documented. Comparing the high SBP-TTR (75%-100%) with the low SBP-TTR (0%-25%) group, the multivariable HRs were 0.67 (95% CI: 0.59-0.76) for CVD, 0.76 (95% CI: 0.56-1.02) for myocardial infarction, and 0.64 (95% CI: 0.56-0.74) for stroke. In addition, the association between SBP-TTR and CVD risk was stronger among individuals aged <65 years than their older counterparts (P for interaction <0.001).

CONCLUSIONS: A greater percentage of SBP-TTR was associated with a lower risk of CVD among patients with hypertension. These findings underscore the importance of maintaining SBP within the target range for the prevention of CVD among hypertensive individuals.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
JACC: Advances
article number
101702
publisher
American College of Cardiology
external identifiers
  • pmid:40243985
ISSN
2772-963X
DOI
10.1016/j.jacadv.2025.101702
language
English
LU publication?
yes
additional info
Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.
id
54d0aa72-bae1-4e75-8742-16d354901182
date added to LUP
2025-05-07 13:57:12
date last changed
2025-05-08 08:21:01
@article{54d0aa72-bae1-4e75-8742-16d354901182,
  abstract     = {{<p>BACKGROUND: Previous post hoc analyses of clinical trials have suggested that a higher percentage of systolic blood pressure time in target range (SBP-TTR) was associated with a decreased risk of cardiovascular disease (CVD). However, there is limited evidence from large prospective cohort studies on the relationship between long-term SBP-TTR and the risk of CVD.</p><p>OBJECTIVES: The purpose of this study was to assess the association between long-term SBP-TTR and the risk of CVD in adults with hypertension.</p><p>METHODS: This study included 26,929 hypertensive patients (mean age 52.8 ± 10.7 years; 83.1% males), free of CVD at baseline from the Kailuan Study. Blood pressure was measured biennially from 2006 to 2012, and the SBP target range was defined as 120 to 140 mm Hg. SBP-TTR was calculated by the Rosendaal linear interpolation method. Incident CVD events were ascertained via the linkage of electronic health record data.</p><p>RESULTS: During a median follow-up of 8.6 years, 2,565 CVD, including 472 myocardial infarction and 2,151 stroke cases were documented. Comparing the high SBP-TTR (75%-100%) with the low SBP-TTR (0%-25%) group, the multivariable HRs were 0.67 (95% CI: 0.59-0.76) for CVD, 0.76 (95% CI: 0.56-1.02) for myocardial infarction, and 0.64 (95% CI: 0.56-0.74) for stroke. In addition, the association between SBP-TTR and CVD risk was stronger among individuals aged &lt;65 years than their older counterparts (P for interaction &lt;0.001).</p><p>CONCLUSIONS: A greater percentage of SBP-TTR was associated with a lower risk of CVD among patients with hypertension. These findings underscore the importance of maintaining SBP within the target range for the prevention of CVD among hypertensive individuals.</p>}},
  author       = {{Huo, Zhenyu and Wu, Shouling and Li, Liuxin and Zhang, Jingdi and Liu, Yang and Han, Xu and Chen, Shuohua and Wang, Guodong and Li, Yun and Zhang, Shunming and Borné, Yan and Geng, Tingting and Huang, Zhe}},
  issn         = {{2772-963X}},
  language     = {{eng}},
  month        = {{04}},
  publisher    = {{American College of Cardiology}},
  series       = {{JACC: Advances}},
  title        = {{Long-Term Systolic Blood Pressure Time in Target Range and Cardiovascular Disease in Individuals With Hypertension}},
  url          = {{http://dx.doi.org/10.1016/j.jacadv.2025.101702}},
  doi          = {{10.1016/j.jacadv.2025.101702}},
  year         = {{2025}},
}