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REFLECTIONS
Hypertension
Hypertension Global Newsletter #8 2025

BLOOD PRESSURE TARGET Hypertension

Systolic blood pressure time in target range within 24 hours and incident heart
failure: insights from the real-world setting
Tian X, et al. Hypertens Res. 2025 Jan;48(1):223-232.

Heart failure (HF) affects approximately 26 million people worldwide. Given its increasing incidence and the lack of curative
treatment, a key strategy for HF prevention involves quantifying hypertension control by measuring systolic blood pressure (SBP)
time in target range (TTR, the proportion of time that a specific measurement remains within a predefined target range). It remains
unknown if the value of a short-term SBP TTR helps predict major cardiovascular events, like HF, in the general population.

Using data from the Kailuan study, a prospective cohort study in Tangshan, China initiated in 2006, this retrospective analysis aimed
to investigate the association of 24-hour SBP TTR with the risk of incident HF in the general population, as well as to compare the
incremental value of SBP TTR, variation, and mean SBP in predicting HF risk.

Included in the analysis were 5152 participants who underwent 24-hour ambulatory BP monitoring and who did not have HF at the
start of the study. The mean age was 61.4 years, with 73% of the participants being men.

The SBP target range was defined as 110–140 mmHg, and SBP TTR was calculated as the percentage of time spent in this range.
Participants were divided into four SBP TTR groups: 0 to <25%, 25 to <50%, 50 to <75%, and 75 to 100%, and were followed for a
median of 6.96 years, during which instances of HF were identified.

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