INDICATOR OF BLOOD PRESSURE CONTROL “TIME IN TARGET RANGE” AND LEFT VENTRICLE HYPERTROPHY IN A 12-YEAR FOLLOW–UP OF POPULATION COHORT

Objective: The “time in target range” for blood pressure control (TTR-BP) might be an important instrument of hypertension (HT) management. The data of TTR-BP application in the longitudinal studies are scarce. We aimed to generate TTR-BP ratio for long-term follow-up, and to study its relationship with HT-mediated organ damage, specifically left ventricular (LV) phenotypes in a 12-year follow–up of population cohort. Design and method: A random population sample (n=9360; 45-64) was examined at baseline in 2003-2005 and re-examined twice after 3 and 12 years (waves 2 and 3; HAPIEE project arm). The hypertensives receiving antihypertensive treatment (AHT) were classified as efficient HT control (EHTC) and inefficient HT control (IHTC) categories for three waves. Using repeated BT measurements and available periods of follow-up, we constructed the TTR-BP ratio as a proportion of EHTC time to the full time of follow-up of individuals. Echocardiographic data in a subsample (n=1004) of wave 3 were used as a proxy indicator of HT-mediated LV damage. Results: Among hypertensives receiving AHT, 44.2% of participants had TTR-BP ratio=0; 5.8% controlled BP up to 15% of the time (TTR-BP ratio<15%); 26.7% controlled BP from 15% to 50% of the time, and 23.3% controlled BP more than 50% of the follow-up time (TTR-BP ratio>50%). The LV myocardium mass (p<0.004), LV mass index (p<0.012), LV diameter (p<0.048), and septal thickness (p<0.0001) significantly differed by these groups of TTR-BP ratio, with lowest values in those with TTR-BP ratio>50%. In age-, sex-adjusted logistic regression, the risk of LVH increased by 41% in those with TTR-BP ratio=0%, by 25% among those with TTR-BP ratio<15%, and by 86% among those with TTR-BP ratio<50% (OR = 1.86; 95%CI: 1.13–3.04; p=0.014) vs. TTR-BP ratio>50%. The latter association was independent of systolic BP, BMI, diabetes, CVD, alcohol consumption, education in multivariable-adjusted model. Conclusions: In the studied population cohort, the TTR-BP ratio during 12-year follow-up was consistently inversely associated with the quantitative expression of the degree of HT-mediated LV damage, and the discrete phenotype of LV hypertrophy was associated with TTR-BP ratio below 50% of the follow-up time. Supported by RSF 24-15-00433.