Association of Systolic Blood Pressure Time in Target Range With Cardiovascular Events Among PRECISION Participants

Area of Science:

• Cardiovascular Medicine
• Clinical Trials
• Hypertension Management

Background:

• Blood pressure (BP) is a vital sign characterized by inherent variability.
• New metrics assessing BP variability and long-term control, such as time in target range (TTR), are emerging.
• TTR quantifies the percentage of time a patient's BP remains within a predefined therapeutic range.

Purpose of the Study:

• To investigate the association between systolic blood pressure (SBP) TTR and major adverse cardiovascular events (MACE).
• To analyze SBP TTR using both traditional and Rosendaal linear interpolation (RLI) methods within the PRECISION trial cohort.

Main Methods:

• Analysis of SBP TTR in 20,487 participants from the PRECISION cardiovascular outcomes trial.
• Categorization of participants based on SBP TTR: <25%, 25%-<50%, 50%-<75%, and ≥75%.
• Generation of hazard ratios (HR) and Kaplan-Meier survival curves to assess MACE risk.

Main Results:

• A significantly lower risk of MACE was observed in participants with ≥75% SBP TTR compared to those with <25% TTR.
• Adjusted HR for MACE was 0.70 (95% CI 0.52-0.95, p=0.02) using the traditional method.
• Adjusted HR for MACE was 0.56 (95% CI 0.43-0.75, p<0.001) using the RLI method.

Conclusions:

• Higher systolic blood pressure time in target range is associated with a reduced risk of major adverse cardiovascular events.
• TTR is a valuable metric for assessing long-term BP control and cardiovascular risk.
• Findings support the importance of achieving and maintaining optimal BP control to mitigate cardiovascular events.