Maintaining SBP Within 120-140 mmHg May Reduce Atherosclerosis Risk, Study Finds

The researchers analyzed data from 7,738 hypertensive participants enrolled in the Kailuan study, all of whom underwent comprehensive health evaluations, including carotid ultrasonography. The focus of the study was the "time in target range" (TTR) for SBP, a measure of how consistently an individual's blood pressure remained within the ideal 120–140 mmHg range. Participants were stratified into four quartiles based on their SBP-TTR.

The key findings include the following:

• Individuals who maintained systolic blood pressure (SBP) within the target range had significantly lower carotid intima-media thickness (cIMT), an early marker of atherosclerosis.
• These individuals were also less likely to have carotid atherosclerotic plaques (CAPs), which are linked to future cardiovascular events.
• Each standard deviation increase in SBP time in the target range (SBP-TTR) was associated with a 0.018 mm reduction in cIMT.
• A standard deviation increase in SBP-TTR also led to a 10.6% reduction in the risk of developing carotid plaques.
• The associations remained significant even after adjusting for factors such as age, sex, body mass index, baseline SBP, and use of antihypertensive medications.
• The findings suggest that stable SBP is an independent protective factor against carotid atherosclerosis, beyond the influence of conventional risk factors.

“Our findings point to a clear inverse relationship between SBP-TTR and carotid atherosclerosis,” the authors noted. “This highlights the importance of maintaining stable blood pressure levels over time to mitigate long-term vascular risks in hypertensive individuals.”

The results support a growing emphasis on achieving target blood pressure and minimizing fluctuations, which can be equally damaging over time. Traditional hypertension management has often focused on achieving a single BP reading goal, but this study shifts the conversation toward consistency in blood pressure control as a marker of cardiovascular health.

"This research contributes to growing evidence that consistent management of systolic blood pressure (SBP) within the 120–140 mmHg range may help reduce the burden of atherosclerotic changes in individuals with hypertension," the researchers noted. They concluded that "long-term strategies focused on enhancing blood pressure stability could play a crucial role in lowering the risk of stroke, myocardial infarction, and other cardiovascular events."

Reference:

Li, W., Liu, Z., Zhao, J., Wu, S., Chen, S., Huang, W., Liu, X., & Gao, Y. (2025). Association of systolic blood pressure time in target range with carotid atherosclerotic plaque and carotid intima-media thickness in hypertensive patients. Scientific Reports, 15(1), 1-8. https://doi.org/10.1038/s41598-025-01217-6