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May 23, 2026American Journal of Hypertension

Effects of Time in Target Range of Systolic Blood Pressure Control on New-Onset Cardiovascular Diseases and All-Cause Mortality in Young and Middle-Aged Adults with Hypertension

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Why the study?

The impact of time in target range of systolic blood pressure on cardiovascular disease and all-cause mortality had not yet been elucidated in young and middle-aged adults with hypertension.

Does a higher time in target range of systolic blood pressure reduce new-onset cardiovascular disease and all-cause mortality in young and middle-aged adults with hypertension?

Population

21,855 participants under 60 with hypertension in the Kailuan study

Comparison

Groups across increasing time in target range of systolic blood pressure (120 to 140 mm Hg)

Design

Longitudinal cohort analysis

Follow-up

Through December 2022

Key result

Higher systolic blood pressure time in target range (120-140 mm Hg) was associated with up to a 31% decreased risk for new-onset CVD and a 34% decreased risk for all-cause mortality.

Authors

DLDonglei LuoHLHongmin LiuJZJingdi Zhang

Discussion

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Overview

Supports SBP-TTR monitoring in young hypertensives; leaves open whether targeting it improves outcomes in trials.

Key Points

  • To explore the relationship between time in target range of systolic blood pressure and the risks of cardiovascular disease and all-cause mortality in younger adults with hypertension.
  • Longitudinal analysis from the Kailuan study involving participants under 60 with hypertension.
  • Target range for systolic blood pressure defined as 120 to 140 mm Hg, assessed from 2006 to 2016.
  • Primary outcomes included new-onset cardiovascular disease and all-cause mortality through December 2022.
  • 1,969 cardiovascular disease events and 1,290 all-cause deaths documented.
  • Higher time in target range associated with a 12%, 14%, and 31% reduced risk of new-onset cardiovascular disease across increasing groups.
  • Mortality rates decreased by 9%, 12%, and 34% with higher SBP time in target range.

Study Design

Type

Cohort (n=21,855)

Structured PICO

Does a higher time in target range of systolic blood pressure reduce new-onset cardiovascular disease and all-cause mortality in young and middle-aged adults with hypertension?

P
Population
21,855 young and middle-aged adults (under 60 years) with hypertension per 2018 ESC/ESH guidelines from the Kailuan study, 82.7% male. Key inclusion: underwent at least three health assessments from 2006 to 2016.
I
Intervention
Higher time in target range of systolic blood pressure (SBP-TTR), with target range defined as 120 to 140 mm Hg
C
Comparator
Lower time in target range of systolic blood pressure (SBP-TTR)
O
Outcome
New-onset cardiovascular disease (CVD) and all-cause mortality through December 2022hard clinical

Main Result

Effect estimate: Risk reduction 31% (CVD) and 34% (mortality) in highest SBP-TTR group

In young and middle-aged adults with hypertension, maintaining systolic blood pressure within the target range of 120-140 mmHg for a greater proportion of time is associated with progressively lower risks of new-onset cardiovascular disease and all-cause mortality.

Cite This Study

Luo et al. (2026) conducted a cohort in Hypertension (n=21,855). Time in target range of systolic blood pressure (SBP-TTR) vs. Lower SBP-TTR groups was evaluated on New-onset CVD and all-cause mortality (Risk reduction 31% (CVD) and 34% (mortality) in highest SBP-TTR group). Higher systolic blood pressure time in target range (120-140 mm Hg) was associated with up to a 31% decreased risk for new-onset CVD and a 34% decreased risk for all-cause mortality.

synapsesocial.com/papers/6a1146bb48a409a3a49e0007https://doi.org/10.1093/ajh/hpag050
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