Abstract: FR-PO0380
Blood Pressure Time-in-Target Range in CKD
Session Information
- Hypertension and CVD: Clinical - 2
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Dweekat, Mo'tasem Zuhier (M. R.), University Hospitals, Cleveland, Ohio, United States
- Chen, Zhengyi, Case Western Reserve University, Cleveland, Ohio, United States
- Wang, Ming, Case Western Reserve University, Cleveland, Ohio, United States
- Rahman, Mahboob, University Hospitals, Cleveland, Ohio, United States
Background
Blood pressure (BP) Time-in-target-range (TTR) has emerged as a new approach to evaluate BP control. TTR indicates the proportion of time BP remained within a predefined target and may be a more comprehensive assessment of BP control compared to single BP readings. There is limited data evaluating BP TTR in patients with CKD.
The objective of this analysis was to determine clinical and demographic factors associated with BP TTR, and the association of BP TTR with clinical outcomes in a cohort of patients with CKD.
Methods
In the Chronic Renal Insufficiency Cohort (CRIC) study, BP was measured at yearly visits by trained staff using a standardized protocol. TTR was defined by the percent of visits between baseline and year 5 with BP <130/80 mm Hg. Renal outcomes were defined as a composite of ESRD or 50% decline in eGFR. Cardiovascular outcomes were defined as a composite of myocardial infarction, stroke, heart failure and peripheral arterial disease. Ordinal logistic regression was used to determine factors associated with BP TTR, and Cox proportional Hazards modelling was used to study association of BP TTR with all-cause mortality, while Fine-Gray subdistribution hazard models were applied to assess the association between BP TTR and renal and cardiovascular outcomes.
Results
Study participants had a mean age of 58.5 years and a mean eGFR of 43 at baseline. Of the 1908 participants followed for 5 years, 430 (22%) had a BP TTR <25%. Participants with TTR <25% were more likely to be non-Hispanic black (Odds ratio (OR) 2.77), Hispanic (OR 3.79), have urine protein >0.22 gram/24 hours (OR 1.90), and use a higher number of antihypertensives (OR 1.10). ACE/ARB use was less likely to be associated with TTR <25% (OR 0.76).
Conclusion
BP TTR less than 25% is common in a well-characterized and closely followed cohort of patients with CKD. Clinical and demographic factors (race, proteinuria, number of antihypertensive drugs and ACE/ARB use) are associated with TTR. Lower TTR is independently associated with a higher risk of renal, cardiovascular outcomes and mortality. TTR over the previous 5 years appears to provide better information about risk of clinical outcomes than BP at a single point in time.
Funding
- NIDDK Support