PloS one
Longitudinal blood pressure trajectories and time to stroke among hypertensive patients: A Bayesian multivariate joint modeling study in Benishangul-Gumuz, Ethiopia
By Assefa SK, Tadesse K, Yenus S and 9 others.
Abstract
Background
Stroke is a major cause of morbidity and mortality worldwide, with hypertension being its most important modifiable risk factor. Although the association between elevated blood pressure and stroke is well established, the extent to which longitudinal blood pressure patterns influence the timing of stroke remains poorly understood, particularly in low-resource settings. We investigated the association between longitudinal systolic and diastolic blood pressure trajectories and time to stroke among hypertensive patients in Ethiopia.
Methods
We conducted a retrospective cohort study of 494 newly diagnosed hypertensive patients receiving follow-up care at two general hospitals in Benishangul-Gumuz, Ethiopia, between January 1, 2015, and September 1, 2024. Time to stroke was analyzed using a Cox proportional hazards model, while repeated systolic and diastolic blood pressure measurements were modelled using linear mixed-effects models. The longitudinal and survival processes were jointly estimated using a Bayesian multivariate joint modelling framework. Posterior adjusted hazard ratios (AHRs) with 95% credible intervals (CrIs) were estimated.