Effects of Time in Target Range of Systolic Blood Pressure Control on New-Onset Cardiovascular Diseases and All-Cause Mortality in Young and Middle-Aged Adults with Hypertension
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ID: 314610
2026
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Abstract
BACKGROUND: The impact of the time target range of systolic blood pressure (SBP-TTR) on cardiovascular disease (CVD) and all-cause mortality has not yet been elucidated in the young and middle-aged adult subjects with hypertension. We detail the possible relationship between SBP-TTR and the risk of new-onset CVD and all-cause mortality among young and middle-aged adult subjects with hypertension. METHODS: A longitudinal analysis was conducted within the Kailuan study, involving participants under 60 with hypertension per 2018 ESC/ESH guidelines, who underwent at least three health assessments from 2006 to 2016. The target range for SBP was defined as 120 to 140 mm Hg. SBP-TTR was determined through linear interpolation of systolic blood pressure (SBP) measurements during health exams until 2017. Primary outcomes included new-onset CVD and all-cause mortality through December 2022. RESULTS: The cohort included 21,855 participants (82.7% male) with an average SBP of 144.59 mmHg. The average SBP-TTR was 39%. 1,969 CVD events and 1,290 all-cause deaths were documented. Higher SBP-TTR correlated with younger age, greater education, and improved kidney function. Increased SBP-TTR was associated with diminished new-onset CVD and lower all-cause mortality rates. Specifically, risks for CVD decreased by 12%, 14%, and 31%, and for mortality by 9%, 12%, and 34% across increasing SBP-TTR groups. A near-linear dose-response relationship was noted (P for non-linearity = 0.303), confirmed by sensitivity analyses. The stricter SBP control was associated with a lower incidence of CVD. CONCLUSIONS: In middle-aged and younger adults with hypertension, a higher SBP time in target range is associated with progressively lower risks of new-onset CVD and all-cause mortality, underscoring the importance of sustained blood pressure control.
| Reference Key |
openalex_W7162011033
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| Authors | Donglei Luo, Hongmin Liu, Jingdi Zhang, Nan Zhang, Zhiqiang Zhao, H X Wang, Ying Liu, G Wang, S H Chen, Enzhao Liu, Wenfeng Shangguan, Yubing Guo, Gary Tse, S L Wu, Tong Liu |
| Journal | American Journal of Hypertension |
| Year | 2026 |
| DOI |
10.1093/ajh/hpag050
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| URL | |
| Keywords | Keywords not found |
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