Time in therapeutic range: timely in hypertension therapeutics?

Elevated blood pressure ranks among the most important modifiable risk factors for premature death, and disability from hypertension mediated organ damage in the world. Many studies attest to the value of lifestyle adjustments and pharmacologic therapy in improving outcomes in patients with hypertension. Since blood pressure is a dynamic vitals sign, variability in visit-to-visit measurements is expected. While guidelines recommend a goal blood pressure, increasing attention is centered on how often a patient's blood pressure is found to be not only below the recommended goal value, but also how much of the time the blood pressure is below what is considered a safe lower goal threshold for blood pressure. In this Perspective we review a relatively new technique in addressing adequacy of blood pressure treatment, the time in therapeutic range, and provide examples supporting the clinical relevance of this novel metric.