Blood Pressure States Transition Inference Based on Multi-State Markov Model

Area of Science:

• Cardiovascular Health
• Public Health Research
• Biostatistics

Background:

• Hypertension risk factors are well-studied, but natural progression from non-hypertensive to hypertensive states remains underexplored.
• Understanding these transitions is crucial for developing effective, proactive interventions.

Purpose of the Study:

• To investigate transition patterns between normal, elevated, and hypertensive blood pressure states in the US working population.
• To identify key risk factors, particularly body mass index (BMI), influencing hypertension progression.

Main Methods:

• A multi-state Markov model was employed.
• Utilized 88,966 clinical records from 34,719 participants screened between 2012-2018.
• Analyzed transition probabilities, survival probabilities, and sojourn times stratified by BMI, age, and gender.

Main Results:

• Body mass index (BMI) emerged as the most critical factor for new-onset hypertension.
• Underweight individuals were more likely to remain in non-hypertensive states, while extremely obese individuals had a higher risk of developing hypertension.
• Significant gender-based differences in transition patterns and sojourn times were observed; for example, normal-weight females spent longer in the normal state than males.

Conclusions:

• Body mass index (BMI) and gender significantly influence hypertension progression trajectories.
• A web-based GUI tool was developed to visualize intervention impacts on delaying hypertension.
• Findings offer insights for targeted, proactive hypertension management strategies.