The Impact of Time-in-Target Range for Systolic Blood Pressure on Left Ventricular Hypertrophy

Abstract BACKGROUND We aimed to explore the association between systolic blood pressure time-in-target range (SBP-TTR) and left ventricular hypertrophy (LVH). METHODS A total of 33,818 participants of the Kailuan Study who underwent echocardiography and had participated in at least two health checkups between 2006 and 2020. The target SBP ranges are defined as 120–140 and 110–130 mmHg, respectively. SBP-TTR was calculated by linear interpolation. Poisson regression models were used to assess relative risk (RR) and 95% confidence intervals (CIs) for the associations of 120–140 and 110–130 mmHg SBP-TTR with LVH. RESULTS When the SBP target range was defined as 120–140 mmHg, in multivariable-adjusted models, compared to the reference group (SBP-TTR ≤25%), LVH risk was significantly reduced in the 75% < SBP-TTR ≤ 100% group, (RR: 0.94, 95% CI: 0.89–0.99). When the SBP target range was defined as 110–130 mmHg, compared to the reference group (SBP-TTR ≤25%), there was significantly reduced in LVH risk in the 25% < SBP-TTR ≤ 50% (RR: 0.89, 95%CI: 0.83-0.94), 50%<SBP-TTR ≤ 75% (RR: 0.85, 95%CI: 0.79-0.91) and 75%< SBP-TTR ≤ 100% (RR: 0.81, 95%CI: 0.76–0.86) groups. Analysis using restricted cubic splines revealed a linear, dose–response relationship between SBP-TTR and LVH risk. CONCLUSIONS With increased SBP-TTR associated with a reduced risk of LVH, demonstrating a clear dose–response relationship. Compared to an SBP-TTR range of 120–140 mmHg, maintaining SBP-TTR at 110–130 mmHg more effectively reduces LVH risk.