Journal article
Long-term systolic blood pressure time in target and risk of cardiovascular events in older adults: a secondary analysis of the ASPREE cohort
American journal of hypertension
07/02/2026
DOI: 10.1093/ajh/hpag070
PMID: 42390117
Appears in UI Libraries Support Open Access
Abstract
Blood pressure (BP) time in target range (TTR) predicts cardiovascular disease (CVD) in high-risk populations; however, TTR's predictive utility in older adults without prior CVD is uncertain.
We performed a post-hoc analysis of the ASPirin in Reducing Events in the Elderly trial and its observational follow-up. Systolic BP TTR for <140 and <130 mmHg was estimated for each participant using BPs from the first three visits. Participants with 0% or 100% TTR were categorized separately, and remaining participants grouped into tertiles using linear interpolation to estimate TTR. Cox proportional hazards models evaluated associations between TTR and adjudicated incident CVD and major adverse cardiovascular events (MACE) after the TTR estimation period, with 0% TTR as reference.
Among 16,730 predominantly white Australian adults (mean age, 74 years) followed for a mean of 7.7 years after TTR estimation, 100% TTR <140 mmHg had reduced risk of CVD (HR, 0.81 [95% CI, 0.68-0.96]; P = .01), while 100% TTR <130 mmHg had reduced risks of CVD (HR, 0.82 [95% CI, 0.67-0.99]; P = .04) and MACE (HR, 0.72 [95% CI, 0.57-0.91]; P < .01). Associations were strongest among women, antihypertensive users, frail/pre-frail participants, and those younger than median age. Findings were consistent after adjusting for competing risk of non-CVD death, when the TTR estimation period was extended an additional year, and when estimated using proportion of individual visit BPs at target.
Longer systolic BP TTR was associated with reduced risk of cardiovascular events in older adults, underscoring the importance of sustained BP control with aging.
Details
- Title: Subtitle
- Long-term systolic blood pressure time in target and risk of cardiovascular events in older adults: a secondary analysis of the ASPREE cohort
- Creators
- Michael E Ernst - University of IowaKatherine L Webb - Monash UniversityRaj C Shah - Rush University Medical CenterLawrence Beilin - Royal Perth HospitalAlice Owen - Monash UniversitySuzanne G Orchard - Monash UniversityMichelle A Fravel - University of IowaRobyn L Woods - Monash UniversityMark R Nelson - University of TasmaniaKevan R Polkinghorne - Monash UniversityNigel Stocks - The University of AdelaideRory Wolfe - Monash UniversityJordana B Cohen - University of PennsylvaniaChristopher M Reid - Curtin University
- Resource Type
- Journal article
- Publication Details
- American journal of hypertension
- DOI
- 10.1093/ajh/hpag070
- PMID
- 42390117
- NLM abbreviation
- Am J Hypertens
- ISSN
- 1941-7225
- eISSN
- 1941-7225
- Publisher
- Oxford University Press; OXFORD
- Grant note
- National Health and Medical Research Council of Australia: 334037, 1127060 Monash University Victorian Cancer Agency NIA and NCI National Institutes of Health: U01AG029824 ASPREE-XT: U19AG062682 National Institute on Aging (NIA) and the National Cancer Institute (NCI)
The ASPirin in Reducing Events in the Elderly (ASPREE) trial was supported by grants from the National Institute on Aging (NIA) and the National Cancer Institute (NCI) at the National Institutes of Health (U01AG029824); the National Health and Medical Research Council of Australia (334037 and 1127060); Monash University (Melbourne, VIC, Australia); and the Victorian Cancer Agency (Australia). ASPREE-XT was supported by U19AG062682 from NIA and NCI.
- Language
- English
- Electronic publication date
- 07/02/2026
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9985179097102771
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