Association of systolic blood pressure time in target range with carotid atherosclerotic plaque and carotid intima-media thickness in hypertensive patients

To examine the associations between the systolic blood pressure (SBP) time in target range (TTR) and carotid atherosclerosis indicators: carotid intima-media thickness (cIMT) and carotid atherosclerotic plaques (CAPs). We conducted a cross-sectional analysis of 7738 hypertensive participants from the Kailuan study who completed a health examination and carotid ultrasonography. TTR was estimated using linear interpolation method, with SBP falling within 120-140 mmHg. Participants were categorized into four groups according to quartiles of SBP-TTR. Logistic and multivariate linear regression were used to study the associations between SBP-TTR and cIMT/CAPs. Compared with the SBP-TTR < 25% group, cIMT gradually decreased in the other three groups and the cIMT decreased by 0.018 mm for every standard deviation increase in SBP-TTR. Additionally, compared to the SBP-TTR < 25% group, the incidence rates of CAPs were lower in the other three groups. Each one standard deviation increase in SBP-TTR was associated with a 10.6% decrease in the risk of CAPs (0.894 [95% CI 0.814 to 0.982]). Those associations were found independent of conventional risk factors. Our study indicates a negative correlation between SBP-TTR and carotid atherosclerosis among hypertensive individuals. Stabilizing blood pressure within normal ranges could reduce cardiovascular risks in hypertensive patients.