Blood Pressure Time in Target Range Within 24 Hours and Cardiovascular Diseases and Mortality: Perspectives From a Real-World Cohort Study

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings Pub Date : 2025-04-01 DOI:10.1016/j.mayocp.2024.08.012

Xue Tian PhD , Yijun Zhang PhD , Shuohua Chen MD , Xue Xia PhD , Qin Xu PhD , Yi Wang MD , Shouling Wu MD , Anxin Wang PhD

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引用次数: 0

Abstract

Objective

To investigate the association of 24-hour, daytime, and nighttime ambulatory systolic blood pressure (SBP) time in target range (TTR) with the risk of cardiovascular disease (CVD) and mortality in real-world settings.

Patients and Methods

Data were obtained from the Kailuan study. Systolic blood pressure TTR was calculated using linear interpolation, with 110 to 140 mm Hg as the target range. Cox regressions were performed to assess the associations of SBP TTR with outcomes.

Results

Among 5099 participants in this analysis, 396 cases of CVD (7.77%) and 490 cases of all-cause mortality (9.61%) occurred during a median follow-up of 6.96 years. After multivariable adjustment, each 1-SD increment in 24-hour SBP TTR was associated with an 11% lower risk of CVD (hazard ratio [HR], 0.89; 95% CI, 0.79 to 0.99; P=.008) and all-cause mortality (HR, 0.89; 95% CI, 0.81 to 0.98; P=.01). Consistently, each 1-SD increment in daytime SBP TTR was associated with 14% lower risk of CVD (HR, 0.86; 95% CI, 0.78 to 0.95; P=.005) and 13% lower risk of all-cause mortality (HR, 0.87; 95% CI, 0.79 to 0.95; P=.003). However, the associations for nighttime SBP TTR did not reach statistically significant levels.

Conclusion

Higher SBP TTR was associated with lower risk of CVD and mortality among Chinese adults in real-world settings. Efforts to attain SBP within 110 to 140 mm Hg over time may be an effective strategy to prevent CVD.

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24小时内血压在目标范围内与心血管疾病和死亡率：来自真实世界队列研究的观点

目的：探讨现实世界中24小时、白天和夜间动态收缩压（SBP）目标范围时间（TTR）与心血管疾病（CVD）风险和死亡率的关系。患者和方法：数据来源于开滦研究。采用线性插值法计算收缩压TTR，目标范围为110 ~ 140 mm Hg。采用Cox回归来评估收缩压TTR与预后的关系。结果：在该分析的5099名参与者中，在中位随访6.96年期间发生了396例CVD（7.77%）和490例全因死亡（9.61%）。多变量调整后，24小时收缩压TTR每增加1 sd，心血管疾病风险降低11%(风险比[HR]， 0.89；95% CI, 0.79 ~ 0.99；P= 0.008)和全因死亡率(HR, 0.89；95% CI, 0.81 ~ 0.98；P = . 01)。与此一致的是，白天收缩压TTR每增加1 sd， CVD风险降低14% (HR, 0.86；95% CI, 0.78 ~ 0.95；P= 0.005)，全因死亡风险降低13% (HR, 0.87；95% CI, 0.79 ~ 0.95；P = .003)。然而，夜间收缩压TTR的相关性没有达到统计学显著水平。结论：在现实世界中，较高的收缩压TTR与较低的心血管疾病风险和死亡率相关。随着时间的推移，努力将收缩压控制在110至140毫米汞柱之间可能是预防心血管疾病的有效策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Mayo Clinic proceedings 医学-医学：内科

CiteScore

16.80

自引率

1.10%

发文量

383

审稿时长

37 days

期刊介绍： Mayo Clinic Proceedings is a premier peer-reviewed clinical journal in general medicine. Sponsored by Mayo Clinic, it is one of the most widely read and highly cited scientific publications for physicians. Since 1926, Mayo Clinic Proceedings has continuously published articles that focus on clinical medicine and support the professional and educational needs of its readers. The journal welcomes submissions from authors worldwide and includes Nobel-prize-winning research in its content. With an Impact Factor of 8.9, Mayo Clinic Proceedings is ranked #20 out of 167 journals in the Medicine, General and Internal category, placing it in the top 12% of these journals. It invites manuscripts on clinical and laboratory medicine, health care policy and economics, medical education and ethics, and related topics.