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.
Cohort (n=21,855)
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?
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.
Effect estimate: Risk reduction 31% (CVD) and 34% (mortality) in highest SBP-TTR group
BACKGROUND: The impact of the time target range of systolic blood pressure (SBP-TTR) on cardiovascular disease (CVD) and all-cause mortality has not yet been elucidated in the young and middle-aged adult subjects with hypertension. We detail the possible relationship between SBP-TTR and the risk of new-onset CVD and all-cause mortality among young and middle-aged adult subjects with hypertension. METHODS: A longitudinal analysis was conducted within the Kailuan study, involving participants under 60 with hypertension per 2018 ESC/ESH guidelines, who underwent at least three health assessments from 2006 to 2016. The target range for SBP was defined as 120 to 140 mm Hg. SBP-TTR was determined through linear interpolation of systolic blood pressure (SBP) measurements during health exams until 2017. Primary outcomes included new-onset CVD and all-cause mortality through December 2022. RESULTS: The cohort included 21,855 participants (82.7% male) with an average SBP of 144.59 mmHg. The average SBP-TTR was 39%. 1,969 CVD events and 1,290 all-cause deaths were documented. Higher SBP-TTR correlated with younger age, greater education, and improved kidney function. Increased SBP-TTR was associated with diminished new-onset CVD and lower all-cause mortality rates. Specifically, risks for CVD decreased by 12%, 14%, and 31%, and for mortality by 9%, 12%, and 34% across increasing SBP-TTR groups. A near-linear dose-response relationship was noted (P for non-linearity = 0.303), confirmed by sensitivity analyses. The stricter SBP control was associated with a lower incidence of CVD. CONCLUSIONS: In middle-aged and younger adults with hypertension, a higher SBP time in target range is associated with progressively lower risks of new-onset CVD and all-cause mortality, underscoring the importance of sustained blood pressure control.
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.