Higher SBP-TTR linked to reduced risks of adverse kidney, CV events in hypertension

In adult patients with hypertension, higher time-in-target range (TTR) for systolic blood pressure (SBP) appears to be associated with lower risks of unfavourable kidney and cardiovascular events, according to a study.

The present analysis involved participants from two clinical trials that compared intensive (<120 mm Hg) and standard (<140 mm Hg) SBP lowering. SBP-TTR for months 0 to 3 was measured using therapeutic ranges of 110–130 mm Hg and 120–140 mm Hg for the intensive and standard arms, respectively.

Adverse kidney events were defined as the composite of dialysis, kidney transplant, serum creatinine >3.3 mg/dL, sustained eGFR <15 mL/(min·1.73 m2), or sustained eGFR decline >40 percent. On the other hand, adverse cardiovascular events included myocardial infarction, stroke, heart failure, and cardiovascular death.

Participants with higher vs lower TTR were younger and less likely to have pre-existing cardiovascular disease. The risk of adverse kidney events was lower among participants with TTR of >0 percent to 43 percent (hazard ratio [HR], 0.57, 95 percent confidence interval [CI], 0.42–0.76; p<0.001), 43 percent to <70 percent (HR, 0.57, 95 percent CI, 0.42–0.78; p=0.001), 70 percent to <100 percent (HR, 0.53, 95 percent CI, 0.38–0.74; p<0.001), and 100 percent (HR, 0.33, 95 percent CI, 0.20–0.57; p<0.001) compared with participants with TTR of 0 percent.

Likewise, the risk of major adverse cardiovascular events was lower for participants with TTR of >0 percent to 43 percent (HR, 0.66, 95 percent CI, 0.52–0.83; p=0.001), 43 percent to <70 percent (HR, 0.70, 95 percent CI, 0.55–0.90; p=0.005), 70 percent to <100 percent (HR, 0.65, 95 percent CI, 0.50–0.84; p=0.001), or 100 percent (HR, 0.56, 95 percent CI, 0.39–0.80; p=0.001) compared with those with TTR of 0 percent.

The findings indicate that SBP-TTR may be a potential therapeutic target and quality metric.