Agarwal Neel, St John Julie, Sunder Vikas, Sarraju Ashish, Laffin Luke J
Ohio State University College of Medicine, Columbus, Ohio, USA.
Cleveland Clinic Coordinating Center for Clinical Research, Cleveland, Ohio, USA.
J Clin Hypertens (Greenwich). 2025 Jul;27(7):e70009. doi: 10.1111/jch.70009.
Blood pressure (BP) is a dynamic vital sign with variability. Novel metrics that account for BP variability and longitudinal control are gaining interest, such as time in target range (TTR) assessments. TTR is the percentage of time a patient's BP is within a desired range. We sought to determine if systolic BP TTR was associated with major adverse cardiovascular events (MACE) among participants in the PRECISION (Prospective Randomized Evaluation of Celecoxib Integrated Safety versus Ibuprofen or Naproxen) trial. PRECISION was a 24 081-participant cardiovascular (CV) outcomes trial comparing celecoxib, naproxen, or ibuprofen in participants with increased CV risk. Systolic BP was in the target range if it was between 110 and 130 mm Hg. TTR was determined via traditional and Rosendaal linear interpolation (RLI) methods. Participants were categorized based on TTR achieved, <25%, 25%-<50%, 50%-<75%, or ≥75%. Hazard ratios (HR) and Kaplan-Meier survival curves were generated. Twenty thousand four hundred and eighty-seven participants had at least four BP readings available for analysis and a median follow-up of 27.6 ± 5.4 months. The cohort had a mean baseline BP of 125.2 mm Hg and a mean systolic BP of 127.5 mm Hg when accounting for all follow-up visits. A lower risk of MACE was observed among individuals with ≥75% TTR compared with those <25% using the traditional (adjusted HR 0.70, 95% CI 0.52-0.95, p = 0.02) and RLI method (adjusted HR 0.56, 95% CI 0.43-0.75, p < 0.001). More systolic BP TTR is associated with a lower risk of MACE among individuals in PRECISION.
血压（BP）是一种具有变异性的动态生命体征。考虑到血压变异性和纵向控制的新指标正受到关注，例如目标范围内时间（TTR）评估。TTR是患者血压处于期望范围内的时间百分比。我们试图确定在PRECISION（塞来昔布综合安全性与布洛芬或萘普生的前瞻性随机评估）试验参与者中，收缩压TTR是否与主要不良心血管事件（MACE）相关。PRECISION是一项有24081名参与者的心血管（CV）结局试验，比较塞来昔布、萘普生或布洛芬在心血管风险增加的参与者中的效果。如果收缩压在110至130mmHg之间，则处于目标范围内。TTR通过传统方法和罗森达尔线性插值（RLI）方法确定。参与者根据达到的TTR进行分类，即<25%、25%-<50%、50%-<75%或≥75%。生成了风险比（HR）和卡普兰-迈耶生存曲线。2487名参与者至少有四次血压读数可用于分析，中位随访时间为27.6±5.4个月。考虑所有随访就诊情况时，该队列的平均基线血压为125.2mmHg，平均收缩压为127.5mmHg。与TTR<25%的个体相比，使用传统方法（调整后HR 0.70，95%CI 0.52-0.95，p = 0.02）和RLI方法（调整后HR 0.56，95%CI 0.43-0.75，p < 0.001）时，TTR≥75%的个体发生MACE的风险较低。在PRECISION试验中，收缩压TTR越高，个体发生MACE的风险越低。
