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Time in target range for systolic blood pressure and glucose with cardiovascular disease and all-cause mortality

Yijun Zhang1,2,3,4, Xue Tian1,2,3,4, Qin Xu1,2,3

  • 1Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|October 31, 2024
PubMed

Insights

Maintaining target blood pressure and blood glucose levels significantly reduces cardiovascular disease and mortality risks in hypertensive and diabetic patients. Achieving higher time in target range for both systolic blood pressure and fasting blood glucose offers substantial protective benefits.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Limited real-world data exists on the combined impact of time in target range (TTR) for systolic blood pressure (SBP) and fasting blood glucose (FBG).
  • Hypertension and diabetes often coexist, increasing cardiovascular disease (CVD) and mortality risks.

Purpose of the Study:

  • To assess the individual and combined effects of SBP TTR and FBG TTR on CVD and all-cause mortality.
  • To provide evidence for managing comorbid hypertension and diabetes.

Main Methods:

  • Utilized data from the Kailuan study, including 11,899 participants with hypertension and diabetes.
  • Defined target ranges as SBP 110-140 mmHg and FBG 3.9-7.0 mmol/L, calculating TTR via linear interpolation.
  • Employed Cox proportional hazard regression models to analyze risks over a 6.67-year follow-up.

Main Results:

  • Higher SBP TTR and FBG TTR were associated with significantly lower risks of CVD and all-cause mortality.
  • Participants with both SBP TTR and FBG TTR above the median had the lowest CVD (HR: 0.53) and mortality (HR: 0.59) risks.
  • Each 1-SD increase in SBP TTR correlated with a 14% reduction in CVD risk and a 10% reduction in mortality risk.

Conclusions:

  • Simultaneous control of SBP and FBG within target ranges is a beneficial strategy for CVD prevention in patients with comorbid hypertension and diabetes.
  • Optimizing both SBP and FBG TTR is crucial for reducing adverse cardiovascular and mortality outcomes.

Keywords:
All-cause MortalityCardiovascular DiseaseFasting Blood GlucoseSystolic Blood PressureTime in Target Range

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