Joint Modeling of Longitudinal Systolic and Diastolic Blood Pressure Measurements of Hypertensive Patients Receiving Treatment

Hypertension is a chronic disease that has a major health problem over thecenturies due to its signicant contribution to the global health burden. Itis also called high blood pressure, described by two numbers Systolic bloodpressure (SBP) and diastolic blood pressure (DBP). Hence, joint longitudinalmodel was used to address how the evolution of SBP is associated with theevolution of DBP. The objective was to investigate the joint evolution andassociation of SBP and DBP measurements of hypertensive patients andidentify the potential risk factors aecting the two end points. In this thisstudy 354 hypertensive patients with age greater than or equal to 18 years,who were on treatment, and who had measured at least three times wereincluded. For a close examination of the separate and joint models, rst, eachof the outcomes was analyzed separately using linear mixed model. Then,a joint model was considered to study the joint evolution and identify thepotential risk factors aecting the two end points. Fit statistics showed thatthe joint model resulted in better t to the data than the separate models.Based on the joint model, sex, baseline age, and place of residence were thesignicant factors for the progression of blood pressure, while family historyand all the interaction term except age by time did not appear signicant.The result from the joint model suggested a strong association between theevolutions and a slowly increasing evolution of the association between SBPand DBP