Does higher systolic blood pressure time-in-target range reduce adverse kidney and cardiovascular events in adults with hypertension?
Higher systolic blood pressure time-in-target range is associated with significantly lower risks of adverse kidney and cardiovascular events in adults with hypertension.
Background: Whether time-in-target range (TTR) for systolic blood pressure (SBP) associates with adverse kidney and cardiovascular events remains incompletely understood. Methods: This study included participants in 2 clinical trials that compared intensive (3.3 mg/dL, sustained eGFR 40%. Adverse cardiovascular events included myocardial infarction, stroke, heart failure, and cardiovascular death. Adjusted Cox proportional hazards regression models were used to estimate the association between SBP-TTR and kidney and cardiovascular events. Results: Participants with higher TTR were younger and less likely to have preexisting cardiovascular disease. Compared with participants with TTR of 0%, the risk of adverse kidney events was lower for participants with TTR of >0% to 43% (hazard ratio 95% CI, 0.57 0.42–0.76; P 0% to 43% (0.66 0.52–0.83; P =0.001), 43% to <70% (0.70 0.55–0.90; P =0.005), 70% to <100% (0.65 0.50–0.84; P =0.001), or 100% (0.56 0.39–0.80; P =0.001) compared with those with TTR of 0%. Conclusions: Higher SBP-TTR associates with lower risks of adverse kidney and cardiovascular events in adults with hypertension. SBP-TTR may be a potential therapeutic target and quality metric.
Buckley et al. (Tue,) studied this question.