Multivariate Joint Analysis of Blood Pressure Measurements and Time to Remission: A Case Study of Hypertensive Patients Receiving Treatment at Jimma University Medical Center

TL;DR

This study explores factors influencing blood pressure changes and remission in hypertensive patients, finding that comorbidities and treatment affect remission time.

Contribution

The paper introduces a multivariate joint model to analyze blood pressure and remission time in hypertensive patients.

Findings

235 out of 369 patients achieved first remission with a median survival time of five months.

Shorter remission time was associated with no comorbidity history, urban residence, combination drug treatment, and younger age.

Changes in systolic and diastolic blood pressure were strongly positively associated (P=0.9923).

Abstract

Background: Hypertension (HTN) elevates blood pressure (BP) in the arteries. It is defined as systolic BP (SBP)>140 mm Hg and/or diastolic BP (DBP)>90 mm Hg. This study aimed to identify determinant risk factors of longitudinal change of SBP and DBP with time to first remission of hypertensive patients.

Study Design: A retrospective cohort study.

Methods: A descriptive and inferential analysis was employed to explore the determinant risk factors, and a multivariate joint model was applied to test the significant association of the possible risk factors.

Results: Of all 369 patients, 235 (63.7%) had first remission with a median survival time of five months. The patients demonstrated shorter first remission time when they had no history of comorbidity, resided in urban areas, took a combination of drugs, and were younger. Similarly, residence, age, treatment, history of diabetes mellitus (DM), history of stroke, and observation time were determinant risk factors of SBP. On the other hand, age, treatment, history of DM, chronic kidney diseases, and observation time were identified as determinant risk factors of DBP. The result revealed a strong positive association between changes in SBP and DBP (P=0.9923). In addition, a significant association was observed between the value of SBP and time to first remission (γ_1=-0.0693, HR=0.993).

Conclusion: Having good follow-ups, receiving control of comorbidity, and taking a combination of drugs show several opportunities for decreasing BP. Consequently, this compels patients to experience the first remission early.

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