THE COMBINED impact of time in target range (TTR) and blood pressure variability (BPV) of systolic blood pressure (SBP) on cardiovascular outcomes and mortality in hypertensive patients was investigated in a prospective cohort study.
The interplay between TTR and BPV of SBP holds significance in assessing risks for major adverse cardiovascular events (MACE) and all-cause mortality in hypertensive individuals. This study aimed to elucidate the joint impact of TTR and BPV on these risks. To do this, it looked at 11,496 hypertensive individuals from the Kailuan cohort, categorising these participants into four groups based on TTR and BPV levels. Using Cox proportional hazards regression models, the study evaluated hazard ratios (HR) and 95% confidence intervals (CI) for MACE and all-cause mortality.
Over a median follow-up of 5.64 years, 839 MACEs (including 99 myocardial infarctions, 591 strokes, and 191 heart failures), and 621 deaths were recorded. Compared to those in the high TTR and low BPV group, individuals in the high TTR and high BPV group faced HRs of 1.309 (95% CI: 1.025–1.671) for MACE and 1.842 (95% CI: 1.373–2.473) for all-cause mortality. Similarly, the low TTR and low BPV group exhibited HRs of 1.692 (95% CI: 1.347–2.125) for MACE and 1.731 (95% CI: 1.298–2.309) for all-cause mortality. Notably, the low-TTR and high-BPV group demonstrated the highest HRs, at 2.132 (95% CI: 1.728–2.629) for MACE and 2.247 (95% CI: 1.722–2.932) for all-cause mortality.
In summary, this study suggests that TTR and BPV of SBP independently contribute to the risk of MACE and all-cause mortality. Particularly, individuals with low TTR and high BPV of SBP face heightened risks of cardiovascular events and mortality among patients with hypertension. This underlines the potential significance of integrating comprehensive management strategies targeting both TTR and BPV in hypertension management.
Reference
Feng Z et al. Combined effect of time in target range and variability of systolic blood pressure on cardiovascular outcomes and mortality in patients with hypertension: a prospective cohort study. J of Clinical Hypertension. 2024;DOI:10.1111/jch.14816.
