Multistate Markov model application for blood pressure transition among the Chinese elderly population: a quantitative longitudinal study.

Abstract

OBJECTIVE:

To explore the transitions of different blood pressure states based on a multistate Markov model among the Chinese elderly population.

SETTING:

A community health centre in Xiamen, China.

PARTICIPANTS:

1833 elderly Chinese people.

METHODS:

A multistate Markov model was built based on 5001 blood pressure measurements from 2015 to 2020. Research was conducted to explore the process of hypertension progression, providing information on the transition probability, HR and the mean sojourn time in three blood pressure states, namely normal state, elevated state and hypertensive state.

RESULTS:

Probabilities of moving from the normal state to the hypertensive state in the first year were 16.97% (female) and 21.73% (male); they increased dramatically to 47.31% (female) and 51.70% (male) within a 3-year follow-up period. The sojourn time in the normal state was 1.5±0.08 years. Elderly women in the normal state had a 16.97%, 33.30% and 47.31% chance of progressing to hypertension within 1, 2 and 3 years, respectively. The corresponding probabilities for elderly men were 21.73%, 38.56% and 51.70%, respectively. For elderly women starting in the elevated state, the probabilities of developing hypertension were 25.07%, 43.03% and 56.32% in the next 1, 2 and 3 years, respectively; while the corresponding changes for elderly men were 20.96%, 37.65% and 50.86%. Increasing age, body mass index (BMI) and glucose were associated with the probability of developing hypertension from the normal state or elevated state.

CONCLUSIONS:

Preventive actions against progression to hypertension should be conducted at an early stage. More awareness should be paid to elderly women with elevated state and elderly men with normal state. Increasing age, BMI and glucose were critical risk factors for developing hypertension. The derived transition probabilities and sojourn time can serve as a significant reference for making targeted interventions for hypertension progression among the Chinese elderly population.

• Authors: Xujuan Zheng, Juan Xiong, Yiqin Zhang, Liping Xu, Lina Zhou, Bin Zhao, Yuxin Wang
• Journal: BMJ open (BMJ Open) Vol. 12 Issue 7 Pg. e059805 (07 14 2022) ISSN: 2044-6055 [Electronic] England
• PMID: 35835530 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Glucose

Topics

• Aged
• Blood Pressure
• China (epidemiology)
• Female
• Glucose
• Humans
• Hypertension (epidemiology)
• Longitudinal Studies
• Male
• Risk Factors