Joint Trajectories of Blood Pressure and Heart Rate and Their Association with Relative Change in Relative Wall Thickness in Hypertensive Patients: A Group-Based Multi-Trajectory Modeling Analysis (Preprint) Article Swipe

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Qi Pan , Nanxiang Zhang , Shuo Yang , Chonglong Ding , Jianan Yin , Yi Fei , Xinyan Zou , Yongjun Zheng , Xiang Huang , Jie-zhen Feng , Hai Lin , Jinxin Zhang ·

YOU? · · 2025 · Open Access · · DOI: https://doi.org/10.2196/preprints.87091

BACKGROUND Introduction: Ambulatory blood pressure monitoring (ABPM) can objectively assess circadian rhythms of blood pressure. However, the joint trajectories of blood pressure (BP) and heart rate (HR) and their association with early cardiac remodeling, particularly changes in relative wall thickness (RWT), remain incompletely characterized. OBJECTIVE Objective: To identify distinct subgroups of hypertensive patients based on joint trajectories of BP and HR using Group-Based Multi-Trajectory Modeling (GBMTM), characterize these groups, and examine their associations with ΔRWT, a marker of cardiac remodeling. METHODS Methods: We enrolled a total of 213 hypertensive patients from three community health centers in Zhongshan City, Guangdong Province, China (November 2022–January 2025). Participants completed four ABPM sessions in 9 months, with 24-hour mean BP and HR recorded. Using GBMTM, we identified joint trajectories of 24-hour mean BP and HR within 9 months. Multivariate linear regression analysis was applied to examine the association of trajectory groups with ΔRWT . RESULTS Results: We identified four joint trajectory groups via GBMTM. Compared with Group 4 (stage 2 hypertension, high heart rate), Group 2 (sustained optimal BP control) showed reduced RWT. Adjusted analyses revealed that antidiabetic medication use was associated with RWT reduction, while waking before 7:00 a.m. was linked to RWT increase. CONCLUSIONS Conclusions: Hypertensive cardiac remodeling exhibits significant differences across different trajectory groups. Stable BP control (even with high HR), glycemic management, and regular sleep patterns exert a protective effect against the development of hypertensive cardiac remodeling.

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Medicine Blood pressure Cardiology Internal medicine Heart rate Ambulatory blood pressure Glycemic Bayesian multivariate linear regression Diastole Joint (building) Ambulatory Diabetes mellitus Circadian rhythm Hemodynamics Linear regression Essential hypertension Association (psychology) Multivariate analysis Electrocardiography Systole Regression analysis

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Landing Page: https://doi.org/10.2196/preprints.87091
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DOI: https://doi.org/10.2196/preprints.87091

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Title: Joint Trajectories of Blood Pressure and Heart Rate and Their Association with Relative Change in Relative Wall Thickness in Hypertensive Patients: A Group-Based Multi-Trajectory Modeling Analysis (Preprint)

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Publication year: 2025

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Publication date: 2025-11-04

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Authors: Qi Pan, Nanxiang Zhang, Shuo Yang, Chonglong Ding, Jianan Yin, Yi Fei, Xinyan Zou, Yongjun Zheng, Xiang Huang, Jie-zhen Feng, Hai Lin, Jinxin Zhang

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Concepts: Medicine, Blood pressure, Cardiology, Internal medicine, Heart rate, Ambulatory blood pressure, Glycemic, Bayesian multivariate linear regression, Diastole, Joint (building), Ambulatory, Diabetes mellitus, Circadian rhythm, Hemodynamics, Linear regression, Essential hypertension, Association (psychology), Multivariate analysis, Electrocardiography, Systole, Regression analysis

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abstract_inverted_index.sessions	113
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abstract_inverted_index.Guangdong	103
abstract_inverted_index.Province,	104
abstract_inverted_index.Zhongshan	101
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abstract_inverted_index.community	97
abstract_inverted_index.completed	110
abstract_inverted_index.different	219
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abstract_inverted_index.thickness	40
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abstract_inverted_index.associations	75
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abstract_inverted_index.particularly	35
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abstract_inverted_index.hypertension,	173
abstract_inverted_index.2022–January	107
abstract_inverted_index.characterized.	44
abstract_inverted_index.Multi-Trajectory	66
abstract_inverted_index.<title>METHODS</title>	85
abstract_inverted_index.<title>RESULTS</title>	157
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abstract_inverted_index.<title>CONCLUSIONS</title>	210
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