One-Year Systolic Blood Pressure and Subsequent Cardiovascular Outcomes After Acute Coronary Syndrome: Insights from a Swiss Prospective Cohort
Authors' conclusion
In this large, predominantly male, well-characterized post-ACS cohort, SBP measured 1 year after ACS showed a J-shaped association with cardiovascular risk, with lowest risk at 130-140 mmHg.
Study context
- Population
- Acute coronary syndrome (ACS) patients alive at 1 year with available systolic blood pressure (SBP) measurementspatients alive at 1 year with available SBP measurements
- Participants
- 2,074 participants
- Exposure
- SBP measured 1 year after ACS and subsequent major adverse cardiovascular events (MACE)
- Outcome
- 3-point MACE:
- Cardiovascular death
- Non-fatal stroke/transient ischemic attack
- Non-fatal myocardial infarction
- Follow-up
- Median 4.0 years
Methodological detailsfour Swiss tertiary-care centers, restricted cubic splines, adjusted
- Four Swiss tertiary-care centers
- Restricted cubic splines
- Adjusted
Main finding
As reported in the abstract
MACE events
229
Incidence
2.7 per 100 patient-years
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted HR (95% CI) | |
|---|---|---|
| MACE per 5-mmHg SBP increase above 140 mmHgBorderline increase in MACE risk | 1.08 (1.00–1.17) | |
| 0.512Adjusted hazard ratio (log scale) |
SBP-MACE relationship
- Nonlinear and J-shaped
- P-non-linearity=0.007
- Lowest risk between ∼130 and 140 mmHg; formally estimated nadir
- 138 mmHg [95%CI 116-152]
Consistency across subgroups (sex, age, hypertension status, diabetes)
- Possible interaction with diabetes could not be excluded
- P for interaction = 0.08
- Pattern broadly consistent across sex, age and hypertension status
Original publication
One-Year Systolic Blood Pressure and Subsequent Cardiovascular Outcomes After Acute Coronary Syndrome: Insights from a Swiss Prospective Cohort. Eur J Prev Cardiol. Published 11 October 2026. doi:10.
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