Relation between blood pressure time in range and composite cardiovascular disease in patients with primary aldosteronism: a retrospective study

Abstract Purpose: To investigate the association between blood pressure (BP) time in range (TIR) and composite cardiovascular disease (CVD) in patients with primary aldosteronism (PA). Methods: Between January 2019 and December 2021, 47 patients with PA were recruited from the First Affiliated Hospital of Xiamen University. Twenty-four-hour ambulatory BP monitoring (ABPM) and composite CVD events were assessed in all patients. Results: The mean age of the patients was 48.8 ± 11.4 years. Compared to PA without composite CVD events, the nighttime systolic BP TIR [31.2% (6.2%, 81.2%) vs. 11.5% (0.0%, 29.7%), p = 0.02] and DDDs of antihypertensive medication [2.0 (1.0, 2.8) vs. 1.0 (1.0, 2.0), p = 0.03] were lower in PA patients with composite CVD events, while higher glucose (5.0 ± 1.0 mmol/L vs. 5.9 ± 1.5 mmol/L) and prevalence of a history of alcohol intake was higher in PA patients with composite CVD events. There were no differences in age, sex, BMI, smoking, duration of hypertension, lipid levels, aldosteronism, clinic BP, 24-hour mean BP, daytime or nighttime BP, percentage of nocturnal SBP or DBP decline, 24-hour BP TIR, daytime BP TIR, or nighttime DBP TIR between the two groups. After adjusting for confounding factors, nighttime systolic BP TIR was significantly associated with composite CVD events (adjusted OR = 0.92 [95% CI 0.86, 0.99]) in multiple logistic regression analysis. Conclusion: Patients with PA and composite CVD events had lower nighttime SBP TIR, suggesting that nighttime BP TIR may be a significant predictor of the prognosis of composite CVD events.