Association of systolic blood pressure time in target range and all-cause mortality in patients with atherosclerotic cardiovascular disease: an analysis of a prospective cohort study.

Higher SBP time in target range (SBP-TTR) was significantly associated with lower all-cause mortality risk in ASCVD patients when the target range was defined as 120–140 mm Hg.

• Compared with the SBP-TTR=0% group, multivariable-adjusted HRs (95% CIs) for all-cause mortality were 0.92 (0.78 to 1.07) for <25%, 0.82 (0.72 to 0.94) for 25% to <50%, 0.79 (0.68 to 0.92) for 50% to <75%, and 0.76 (0.65 to 0.89) for ≥75%.
• For each SD increase in SBP-TTR, the risk of all-cause mortality decreased with a multivariable-adjusted HR of 0.90 (95% CI 0.85 to 0.95).
• The target SBP range was defined as 120–140 mm Hg and SBP-TTR was calculated using the linear interpolation method.
• 6,732 participants who developed ASCVD between 1 July 2006 and 31 December 2013 were included, with follow-up until 31 December 2022.

The inverse association between SBP-TTR and all-cause mortality was significantly more pronounced in younger ASCVD patients.

• The association was more pronounced in participants aged <67 years compared to older participants.
• The p-value for the interaction between age group and SBP-TTR on all-cause mortality was 0.008.
• The age threshold used for subgroup stratification was 67 years.

The study population consisted of ASCVD patients from a prospective cohort with multiple blood pressure measurements captured over an extended period.

• Participants were drawn from the Kailuan Study, involving 11 hospitals affiliated with the Kailuan Group in Tangshan, China.
• Inclusion required two or more blood pressure measurements recorded between the ASCVD diagnosis date and 31 December 2017.
• Participants were stratified into five SBP-TTR categories: 0%, >0% to <25%, 25% to <50%, 50% to <75%, and ≥75%.
• The study is registered under ChiCTR-TNC-11001489.

Sustained and stable blood pressure control within the target range was suggested to improve long-term survival in patients with ASCVD.

• The findings indicate a dose-response relationship, with progressively lower HRs for all-cause mortality as SBP-TTR increased.
• The ≥75% SBP-TTR group had the lowest HR of 0.76 (95% CI 0.65 to 0.89) compared to the 0% group.
• The authors concluded that 'sustained and stable blood pressure control may improve long-term survival in patients with ASCVD.'