The research aimed to illustrate the prognostic value of systolic blood pressure time in target range (SBP-TTR) calculated by continuously monitoring blood pressure (BP) records among patients admitted to coronary care units. Data from the Medical Information Mart for Intensive Care-IV database was used in this retrospective cohort study. Systolic blood pressure (SBP) target ranges were defined as 110-140 mmHg for awake time, and 90-120 mmHg for sleep time, respectively. SBP-TTR was calculated as the proportion of measured SBP in the target range among all SBP measurements, and participants were divided into four groups according to the categories of TTR. We used Cox proportional hazard regression models to assess the association between SBP-TTR and one-year all-cause mortality. A total of 4665 patients with 394,267 BP records were included in the study. During a maximum of 365 follow-up days, the cumulative incidence of all-cause death diminished with the increase of TTR categories. After multivariable adjustment, comparing with the lowest category, the highest category of SBP-TTR showed significantly decreased risk on one-year mortality (HR:0.50, 95%CI 0.36-0.71, P < 0.0001), and 10% increment of TTR was associated with 12% decrease of all-cause mortality (HR:0.88, 95%CI 0.85-0.91, P < 0.0001). In sensitivity analyses, both awake and sleep SBP targets were reset to wider ranges, and the results remained robust. Subgroup analyses generated consistent results across different demographic characteristics, baseline BP levels and comorbidities. There was a negative association between SBP-TTR and one-year all-cause mortality in CCU patients.
Keywords: Blood pressure management; Coronary care unit; Systolic blood pressure; Time in target range.
© 2025. The Author(s).