Long-term blood pressure control assessment using time spent in therapeutic range among Saudi patients

Time in therapeutic range (TTR) is a new approach to monitoring blood pressure (BP), providing a more accurate picture over time compared to the standard single BP measurement during a clinic visit. Currently, no study from Saudi Arabia has explored the use of TTR in assessing BP control and its related factors. Thus, we aimed to investigate them in this study.

Participants aged ≥ 18 years with at least three BP measurements from January 2016 to December 2020 were enrolled. Patient data were collected, including the date of hypertension (HTN) diagnosis, comorbidities, medication history, and laboratory test results. TTR values were calculated, and descriptive statistical analysis was applied to assess the differences between patients with TTR ≥ 50% and those with TTR < 50%. The Poisson regression model was used to describe the associations between patient characteristics and TTR values.

30,694 patients were included, with 74% identified as having TTR < 50%. Female gender, concomitant diabetes mellitus, or cardiovascular diseases were significantly associated with TTR ≥ 50% (p < 0.02). Conversely, increasing age, body mass index, years with HTN, or hyperlipidemia were associated with TTR < 50% (p < 0.001).

According to the 2017 American College of Cardiology and the American Heart Association (ACC/AHA) guidelines, about three-quarters of the patients presented with TTR < 50% among the screened Saudi cohort. The results of this study may raise concerns about clinicians' adherence to the updated HTN management guidelines and patients' compliance with their treatment plans. This underscores the urgent need to improve HTN management and TTR attainment among Saudi patients.