ArticleAmerican journal of preventive cardiology2026
Time in target systolic blood pressure range and cardiometabolic disease-free life expectancy in hypertensive elderly.
Article in American journal of preventive cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Although sustained blood pressure control is known to reduce cardiovascular and renal events, its long-term impact on overall life expectancy and the proportion of life lived free from cardiometabolic disease (CMD) remains insufficiently quantified. Aims: To examine the associations between systolic blood pressure time in target range (SBP-TTR) and total life expectancy, CMD-free life expectancy, and life expectancy lived with CMD among adults with hypertension. Methods: This prospective cohort study included 18,503 adults aged ≥45 years with hypertension from the Kailuan Study (China), followed from 2006 to 2022. SBP-TTR (120-140 mmHg) was assessed over a 6-year exposure period. Multistate life table models were applied to estimate total, CMD-free, and CMD-lived life expectancy across SBP-TTR categories. Results: During a mean follow-up of 11.94 years, 7,393 incident CMD events were identified, including 1,443 deaths after CMD onset. Estimated CMD-free life expectancy increased progressively across SBP-TTR categories, from 38.77 years (95% CI: 38.50-39.05) in the low group to 40.29 years (95% CI: 40.19-40.23) in the high group. Compared with low SBP-TTR, high SBP-TTR was associated with 1.51 additional years of total life expectancy and 6.18 additional CMD-free years, alongside a 4.67-year reduction in CMD-lived life expectancy. Early blood pressure control conferred greater benefits than later control. Conclusion: Higher SBP-TTR is associated with longer life expectancy and, importantly, a greater proportion of life lived free from CMD, supporting SBP-TTR as a clinically meaningful metric for long-term hypertension management.
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