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In patients admitted to coronary care units, the highest category of systolic blood pressure time in target range reduces one-year mortality risk by 50% (HR:0.50, 95%CI 0.36-0.71). Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

January 10, 2026Scientific Reports0 citationsOpen Access

A retrospective analysis of systolic blood pressure time in target range among patients in coronary care unit

QJQiufeng JiaQilu Hospital of Shandong University DYDandan YangUniversity of California, Los Angeles XFXiangrui FuShandong University

Key Result

In patients admitted to coronary care units, the highest category of systolic blood pressure time in target range reduced one-year mortality risk by 50% (HR:0.50, 95%CI 0.36-0.71).

Key Points

The study investigates the relationship between systolic blood pressure time in target range (SBP-TTR) and all-cause mortality in coronary care unit patients.
Utilized data from the Medical Information Mart for Intensive Care-IV database.
Calculated SBP-TTR as the proportion of SBP measurements in the target range.
Divided participants into four groups based on TTR categories.
Employed Cox proportional hazard regression models to evaluate the association with mortality.
Higher categories of SBP-TTR correlated with lower one-year mortality risk.
The highest SBP-TTR category had a hazard ratio (HR) of 0.50, indicating a significant decrease in mortality risk.
Every 10% increase in SBP-TTR was linked to a 12% reduction in all-cause mortality.
Results remained consistent across various sensitivity and subgroup analyses.

Structured PICO

Does higher systolic blood pressure time in target range (SBP-TTR) reduce one-year all-cause mortality in patients admitted to the coronary care unit?

Population

4,665 adults (age ≥18 years) admitted to the coronary care unit (CCU) for >24 hours with ≥20 SBP measurements, mean age 70.32, 56.9% male, US-based (MIMIC-IV database).

Intervention

High systolic blood pressure time in target range (SBP-TTR), defined as 75-100% of measurements within 110-140 mmHg (awake) and 90-120 mmHg (sleep).

Comparator

Low systolic blood pressure time in target range (SBP-TTR), defined as 0-25% of measurements within the target range.

Outcome

One-year all-cause mortalityhard clinical

Higher systolic blood pressure time in target range (SBP-TTR) during coronary care unit admission is independently associated with a significantly decreased risk of one-year all-cause mortality.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

The research aimed to illustrate the prognostic value of systolic blood pressure time in target range (SBP-TTR) calculated by continuously monitoring blood pressure (BP) records among patients admitted to coronary care units. Data from the Medical Information Mart for Intensive Care-IV database was used in this retrospective cohort study. Systolic blood pressure (SBP) target ranges were defined as 110-140 mmHg for awake time, and 90-120 mmHg for sleep time, respectively. SBP-TTR was calculated as the proportion of measured SBP in the target range among all SBP measurements, and participants were divided into four groups according to the categories of TTR. We used Cox proportional hazard regression models to assess the association between SBP-TTR and one-year all-cause mortality. A total of 4665 patients with 394,267 BP records were included in the study. During a maximum of 365 follow-up days, the cumulative incidence of all-cause death diminished with the increase of TTR categories. After multivariable adjustment, comparing with the lowest category, the highest category of SBP-TTR showed significantly decreased risk on one-year mortality (HR:0.50, 95%CI 0.36-0.71, P < 0.0001), and 10% increment of TTR was associated with 12% decrease of all-cause mortality (HR:0.88, 95%CI 0.85-0.91, P < 0.0001). In sensitivity analyses, both awake and sleep SBP targets were reset to wider ranges, and the results remained robust. Subgroup analyses generated consistent results across different demographic characteristics, baseline BP levels and comorbidities. There was a negative association between SBP-TTR and one-year all-cause mortality in CCU patients.

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