Abstract:
Introduction: Hypertension (high blood pressure) is a widespread condition in which the
blood's long-term force on the artery walls is high enough to develop health problems
such as heart disease. The main aim of this paper was to jointly model the longitudinal
change of blood pressures (SBP and DBP) and time to the first remission of hypertensive
outpatients receiving treatment.
Methods: A retrospective study design was used to collect relevant data on longitudinal
changes in blood pressure and time-to-event from the medical charts of 301 hypertensive
outpatients under follow-up at Felege Hiwot referral hospital. The data were explored
using basic descriptive statistics, individual and mean profile plots, Kaplan-Meier plots,
and log-rank tests. To get wide-ranging information about the progression of the disease,
bivariate linear mixed, Cox PH regression, and joint models were employed.
Results: A sample of 301 hypertensive patients who take treatment was taken from FHRH
recorded from September 2017 to February 2021. With an estimated median survival time
of 11 months, 80.7% of patients had their first remission time. The patient’s mean SBP and
DBP under all the visit times were 148.89mmHg and 87.78mmHg respectively. There is a
0.89-fold decrease in risk of the first remission, per doubling of the current true value of
SBP. The evolution/change of SBP and DBP has a strong positive correlation.
Conclusion: A patient who had a good follow-up, lower BUN, lower serum calcium,
lower serum sodium, lower hemoglobin, and take the treatment enalapril shows an
opportunity in decreasing the BPs, consequently, this compels patients to experience the
first remission early. Furthermore, Age, patient’s history of DM, patient's history of
CKD, and treatment type were the joint determinant factors for the longitudinal change
of blood pressure and the first remission time. In conclusion, the Bayesian joint bivariate
model approach provides specific dynamic predictions, provides wide-ranging
information about the disease transitions, and better knowledge of disease etiology.