Systolic Blood Pressure Time in Target Range and Cardiovascular Disease and Premature Death

Previous research has suggested that time-in-target range (TTR) for systolic blood pressure (SBP) was associated with adverse cardiovascular events, but real-world data studies remain limited. The purpose of this study was to estimate the SBP-TTR associated with cardiovascular disease (CVD) and premature death among the employed individuals with hypertension. This study included 9,552 participants from the workplace hypertension management program initiated by the Kailuan Study in 2009. TTR was calculated using linear interpolation with the target range of SBP between 120 and 140 mm Hg. Multivariable Cox regression was used to evaluate the HR and CI for the association among SBP-TTR and CVD, premature CVD, and premature death. Participants with higher TTR exhibited a reduced number of cardiovascular risk factors. For a 1-SD increment in SBP-TTR, the HR was 0.81 (95% CI: 0.74-0.88) for CVD, 0.76 (95% CI: 0.67-0.86) for premature CVD, and 0.83 (95% CI: 0.74-0.92) for premature death. Furthermore, SBP-TTR was associated with a lower risk of ischemic stroke (HR: 0.81; 95% CI: 0.74-0.90) and hemorrhagic stroke (HR: 0.72; 95% CI: 0.56-0.93), but not myocardial infarction (HR: 0.84; 95% CI: 0.68-1.03). Results were similar when the target range of SBP was redefined as 110 to 130 mm Hg, but there was no significant association between SBP-TTR and hemorrhagic stroke (HR: 0.84; 95% CI: 0.64-1.10). SBP-TTR was associated with a decreased risk of CVD, premature CVD, and premature death among the employed individuals.