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Combined effect of time in target range and variability of systolic blood pressure on cardiovascular outcomes and
Zekun Feng1, Yanjie Li2, Chi Wang1
1Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China.
Journal of Clinical Hypertension (Greenwich, Conn.)
|April 23, 2024
Summary
Low time in target range (TTR) and high blood pressure variability (BPV) significantly increase the risk of major adverse cardiovascular events (MACE) and death in hypertensive patients. This combined effect poses a greater risk than either factor alone.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Outcomes
Background:
- Time in target range (TTR) and blood pressure variability (BPV) of systolic blood pressure (SBP) are recognized independent risk factors for major adverse cardiovascular events (MACE) and all-cause mortality in hypertensive patients.
- The combined impact of low TTR and high SBP BPV on these adverse outcomes remains incompletely understood.
Purpose of the Study:
- To investigate the synergistic effect of combined low TTR and high SBP BPV on the risk of MACE and all-cause mortality in a large cohort of hypertensive individuals.
Main Methods:
- Utilized data from 11,496 hypertensive patients in the Kailuan cohort study.
- Categorized participants into four groups based on TTR and SBP BPV levels.
- Employed Cox proportional hazards regression models to assess hazard ratios (HRs) and 95% confidence intervals (CIs) for MACE and all-cause mortality over a median follow-up of 5.64 years.
Main Results:
- A total of 839 MACEs and 621 deaths were recorded during follow-up.
- Compared to the high TTR/low BPV group, the low TTR/high BPV group exhibited the highest risk: HR 2.132 (95% CI: 1.728-2.629) for MACE and HR 2.247 (95% CI: 1.722-2.932) for all-cause mortality.
- Elevated risks were also observed for high TTR/high BPV (MACE HR: 1.309, mortality HR: 1.842) and low TTR/low BPV (MACE HR: 1.692, mortality HR: 1.731) groups.
Conclusions:
- The combination of low TTR and high SBP BPV is significantly associated with an increased risk of MACE and all-cause mortality in hypertensive patients.
- These findings highlight the critical importance of monitoring both TTR and BPV for comprehensive cardiovascular risk assessment and management in hypertension.
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