Systolic Blood Pressure Time in Target Range and Cardiovascular Outcomes in Patients With Hypertension.

Abstract Background Standard blood pressure control metrics may not account for fluctuations in blood pressure over time. Objectives This study sought to estimate the independent association between time in systolic blood pressure target range and major adverse cardiovascular events among adults with hypertension. Methods This study was a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial), a randomized clinical trial that compared intensive ( Results Participants with greater time in target range were younger, had lower 10-year cardiovascular risk and lower baseline systolic blood pressure, and were more likely women and statin users. Each 1-SD increase in time in target range was significantly associated with a decreased risk of first major adverse cardiovascular event in fully adjusted models. Time in target range remained significantly associated with major adverse cardiovascular events despite adjustment for mean systolic blood pressure or systolic blood pressure variability. Among participants with mean systolic blood pressure at or below target, time in target range remained associated with major adverse cardiovascular events. Conclusions Time in systolic blood pressure target range independently predicts major adverse cardiovascular event risk.