European Journal of Cardiovascular Medicine

Chronic hypertension, a major global health concern, contributes significantly to cardiovascular diseases, stroke, and chronic kidney disease. In India, it stands as the seventh leading cause of death. Understanding the dynamics of blood pressure (BP) is crucial for effective management, especially in resource-constrained settings. This study explores the interplay between systolic (SBP) and diastolic (DBP) blood pressure in hypertensive patients, investigating the variables influencing their longitudinal variations. Methods: A prospective follow-up research was conducted at the hypertension clinic in SLN Medical College and Hospital, Odisha. Structured questionnaires captured socio-demographic and clinical variables from 1100 hypertensive patients aged 18 or older, resulting in 4400 observations. Bivariate longitudinal mixed effect models were employed for joint analysis of SBP and DBP evolution over time. Results: The mean SBP and DBP decreased over the 6-month follow-up period. Significant factors influencing SBP and DBP included sex, age, diabetes, coffee consumption, alcohol use, khat chewing, and physical exercise. A joint model indicated a positive correlation between SBP and DBP developments. Discussion: The study revealed a declining trend in both SBP and DBP over time, emphasizing the impact of modifiable risk factors. Sex, age, lifestyle choices, and medical history played significant roles in influencing blood pressure parameters. Regular exercise emerged as a protective factor. Conclusion: The joint mixed effect model provided valuable insights into the correlated dynamics of SBP and DBP. Targeted prevention and management strategies should focus on modifiable risk factors identified in the study. Healthcare professionals can use these findings to tailor interventions for hypertensive patients and impede the progression of hypertension.