Time in systolic BP target range predicts major CV event risk
Among adults with hypertension and high CV risk, greater time with systolic BP within target range predicted reduced risk for major CV events independent of traditional CV risk factors, researchers reported.
Systolic BP time in target range remained an important predictor of CV outcomes even after adjusting for mean systolic BP and systolic BP variability, whereas systolic BP time in target range predicted CV outcomes even among participants with a mean systolic BP within target range, the researchers wrote.
The study was a post hoc analysis of SPRINT that compared intensive (target of < 120 mm Hg) and standard (target of < 140 mm Hg) systolic BP treatment interventions in 6,162 adults with hypertension and high CV risk (mean age, 68 years; 38% women; 17% with history of clinical CVD).
According to the researchers, participants with greater time in target range were younger, had lower 10-year CV risk and lower baseline systolic BP and were more likely to be women and statin users compared with those with lower time in target range. Each 1-standard deviation (SD) increase in time in target range conferred lower risk for first major adverse CV events in fully adjusted models (HR per 1 SD = 0.81; 95% CI, 0.73-0.91; P < .001).
Greater time in target systolic BP range also reduced risk for the following: nonfatal MI (HR per 1 SD = 0.75; 95% CI, 0.62-0.9; P = .002); HF hospitalization (HR per 1 SD = 0.79; 95% CI, 0.65-0.97; P = .023) and major adverse CV events or death (HR per 1 SD = 0.85; 95% CI, 0.78-0.95; P = .001), the researchers wrote.
“These results suggest that time in target range provides incremental value beyond mean systolic blood pressure to population-based hypertension quality monitoring and clinical trial-based blood pressure interventions,” the researchers wrote.