ArticlePloS one2018
Time spent at blood pressure target and the risk of death and cardiovascular diseases.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05841654 (Effect of Azilsartan on the Incidence of Atrial Fibrillation in Patients With Hypertension Combined With Left Ventricular Hypertrophy), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Azilsartan on the Incidence of Atrial Fibrillation in Patients With Hypertension Combined With Left Ventricular Hypertrophy
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Use of Quadruple Therapy in the Management of Hypertension: A Systematic Review of Randomized Controlled Trials.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Systolic blood pressure time-in-target range and kidney outcomes in patients with hypertension: Findings from the STEP trial.Chinese medical journal · 2026Trial
- Trial
- Long-term SBP time in target and risk of cardiovascular events in older adults: a secondary analysis of the ASPREE cohort.American journal of hypertension · 2026Observational
- A randomized crossover clinical trial comparing 24-h blood pressure measurements from two different cuffless wrist ambulatory monitors with cuffed ambulatory monitoring for translation to clinical practice: Rationale and Design of Continuum BP study.American heart journal plus : cardiology research and practice · 2026Article
- Time to death and its predictors among adult hypertensive patients attending public health facilities, Dire Dawa, Eastern Ethiopia: Retrospective cohort study.Journal of public health research · 2025Article
- Chinese Guidelines for the Prevention and Treatment of Hypertension (2024 revision).Journal of geriatric cardiology : JGC · 2025Article
- Time in target range for systolic blood pressure and stroke in people with and without diabetes: the Kailuan prospective cohort study.Frontiers in endocrinology · 2025Article
- Time in target range for systolic blood pressure and glucose with cardiovascular disease and all-cause mortality risks.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Impact of the COVID-19 pandemic on primary care for hypertension in the UK: a population-based cohort study.BMJ open · 2024Article
- Does renal denervation require cardiovascular outcome-driven data?Hypertension research : official journal of the Japanese Society of Hypertension · 2024Review
- Blood Pressure Time in Target Range and its Impact on Clinical Outcomes.Current cardiology reports · 2024Review
- Blood pressure time at target and its prognostic value for cardiovascular outcomes: a scoping review.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Combined effect of time in target range and variability of systolic blood pressure on cardiovascular outcomes and mortality in patients with hypertension: A prospective cohort study.Journal of clinical hypertension (Greenwich, Conn.) · 2024Article
- Optimizing time-in-target-range assessment for blood pressure: insights from a large-scale study with continual cuffless monitoring.Frontiers in medicine · 2024Article
- Late outcomes of renal denervation are more favourable than early ones: facts or fancies?Clinical kidney journal · 2023Review
- Uncontrolled blood pressure and therapeutic inertia in treated hypertensive patients: A retrospective cohort study using a UK general practice database.Journal of clinical hypertension (Greenwich, Conn.) · 2023Article
- Systolic Blood Pressure Time in Target Range and Major Adverse Kidney and Cardiovascular Events.Hypertension (Dallas, Tex. : 1979) · 2023Article
- Blood pressure and its variability: classic and novel measurement techniques.Nature reviews. Cardiology · 2022Review
- Factors Associated With Achievement of Blood Pressure, Low-Density Lipoprotein Cholesterol (LDL-C), and Glycemic Targets for Primary Prevention of Cardiovascular Diseases Among High Cardiovascular Risk Malaysians in Primary Care.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundThe time a patient spends with blood pressure at target level is an intuitive measure of successful BP management, but population studies on its effectiveness are as yet unavailable.
methodWe identified a population-based cohort of 169,082 individuals with newly identified high blood pressure who were free of cardiovascular disease from January 1997 to March 2010. We used 1.64 million clinical blood pressure readings to calculate the TIme at TaRgEt (TITRE) based on current target blood pressure levels.
resultThe median (Inter-quartile range) TITRE among all patients was 2.8 (0.3, 5.6) months per year, only 1077 (0.6%) patients had a TITRE ≥11 months. Compared to people with a 0% TITRE, patients with a TITRE of 3-5.9 months, and 6-8.9 months had 75% and 78% lower odds of the composite of cardiovascular death, myocardial infarction and stroke (adjusted odds ratios, 0.25 (95% confidence interval: 0.21, 0.31) and 0.22 (0.17, 0.27), respectively). These associations were consistent for heart failure and any cardiovascular disease and death (comparing a 3-5.9 month to 0% TITRE, 63% and 60% lower in odds, respectively), among people who did or did not have blood pressure 'controlled' on a single occasion during the first year of follow-up, and across groups defined by number of follow-up BP measure categories.
conclusionBased on the current frequency of measurement of blood pressure this study suggests that few newly hypertensive patients sustained a complete, year-round on target blood pressure over time. The inverse associations between a higher TITRE and lower risk of incident cardiovascular diseases were independent of widely-used blood pressure 'control' indicators. Randomized trials are required to evaluate interventions to increase a person's time spent at blood pressure target.
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Registered trials
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