{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:44:02Z","timestamp":1753868642956,"version":"3.41.2"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370387"],"award-info":[{"award-number":["82370387"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Usual measures of blood pressure (BP) do not account for both the magnitude and duration of exposure to elevated BP over time. We aimed to demonstrate the effect of a novel time\u2010weighted BP on cardiovascular outcomes using a post hoc analysis of two published randomized trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Time\u2010weighted blood pressure is associated with cardiovascular risk among patients with or without diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The limited\u2010access ACCORD and SPRINT data sets were used for the current study. Time\u2010weighted BP is obtained by dividing cumulative BP by the total follow\u2010up time. Time\u2010weighted BP burden above a threshold is also determined after deriving the time\u2010weighted BP by re\u2010zeroing the interpolated pressure values at two different hypertension thresholds (&gt;140\/90 and &gt;130\/80\u2009mmHg).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen thousand five hundred forty\u2010one patients from the two clinical trials were enrolled in this study. A J\u2010curve relation was observed between time\u2010weighted BP and major cardiovascular events (MACE). The systolic blood pressure\u00a0(SBP) burden independently predicted MACE across the two trials at different thresholds (ACCORD: SBP\u2009&gt;\u2009130\u2009mmHg, HR\u2009=\u20091.05 [1.03\u22121.06]; SBP\u2009&gt;\u2009140\u2009mmHg, HR\u2009=\u20091.06 [1.04\u22121.08]; SPRINT: SBP\u2009&gt;\u2009130\u2009mmHg, HR\u2009=\u20091.04 [1.03\u22121.05]; SBP\u2009&gt;\u2009140\u2009mmHg, HR\u2009=\u20091.05 [1.04\u22121.07]). Consistent results were found for diastolic blood pressure (DBP) burden (ACCORD: DBP\u2009&gt;\u200980\u2009mmHg, HR\u2009=\u20091.10 [1.06\u22121.15]; DBP\u2009&gt;\u200990\u2009mmHg, HR\u2009=\u20091.20 [1.11\u22121.30]. SPRINT: DBP\u2009&gt;\u200980\u2009mmHg, HR\u2009=\u20091.06 [1.02\u22121.09]; DBP\u2009&gt;\u200990\u2009mmHg, HR\u2009=\u20091.12 [1.06\u22121.18]). Significant associations were also observed for stroke, myocardial infarction, cardiovascular death, and all\u2010cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Both time\u2010weighted SBP and DBP independently influenced the risk of adverse cardiovascular events among patients with and without diabetes, regardless of the definition of hypertension (130\/80 or &lt;140\/90\u2009mmHg).<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.24213","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T12:22:09Z","timestamp":1705407729000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Time\u2010weighted blood pressure with cardiovascular risk among patients with or without diabetes"],"prefix":"10.1002","volume":"47","author":[{"given":"Zhixin","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2551-2956","authenticated-orcid":false,"given":"Fang","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Nanjing Medical University School of Public Health  Nanjing Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingwen","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0333-8192","authenticated-orcid":false,"given":"Qinyuan","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pestheruwe Liyanaralalage Rosemarrie Krisunika","family":"Cooray","sequence":"additional","affiliation":[{"name":"School of International Education Nanjing Medical University  Nanjing Jiangsu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kangyu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Division of Life Sciences and Medicine,\u00a0The First Affiliated Hospital of USTC University of Science and Technology of China  Hefei China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenqiang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine The University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Chen","sequence":"additional","affiliation":[{"name":"Centre for Health Economics University of York  York UK"},{"name":"Department of Clinical Sciences Liverpool School of Tropical Medicine  Liverpool 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