Prognostic implication of time in target range of systolic blood pressure in patients with hypertension after coronary artery bypass grafting

Abstract

Objective To evaluate the prognostic value of systolic blood pressure (SBP) time in target range (TTR) in patients with hypertension following coronary artery bypass grafting (CABG). Methods We performed a retrospective analysis on patients with hypertension who underwent CABG between January 2022 and May 2024 A total of 528 patients with hypertension after CABG were included in this retrospective analysis. SBP target range was defined as <140 mmHg. The outcome was the occurrence within 1 year of a major adverse cardiac or cerebrovascular event, defined as death from any cause, myocardial infarction, stroke, or repeat revascularization. We used Cox proportional hazards regression models to assess the association of SBP-TTR and clinical outcome. Results A total of 528 patients with hypertension after CABG were included in this post hoc analysis. After multivariable adjustment, a 10% increase in SBP-TTR was associated with 22% decreased risk of adverse events [hazard ratio, 0.78 (95% CI, 0.67–0.90); P = 0.001]. Compared to those with a lower SBP-TTR, patients with SBP-TTR > 75%–100% were characterized by younger age, lower baseline BP, superior rate of DBP goal attainment and medication adherence. Kaplan–Meier curves demonstrated that higher SBP-TTR was associated with a significantly lower event probability over time (Log-rank P < 0.001). Conclusions For hypertensive patients undergoing CABG, a higher SBP-TTR is associated with an improved clinical prognosis. Efforts to enhance medication adherence represent a promising strategy to increase target achievement.