Joint modeling of blood pressure measurement and survival time of hypertension patients

Abstract
Hypertension is a chronic disease that has a major health problem over the centuries due to its significant contribution to the global burden. The objective of this study was to examine the association of survival time and longitudinal Systolic Blood Pressure (SBP) measurement and finding potential barrier that affects SBP measurement and the survival time of hypertension patients. The study considered a cohort of 318 hypertension patients who were aged 18 years or older and were under follow-up from January 1, 2012, to February 30, 2020, at Arba Minch General Hospital. To analyze the data we employed linear mixed effect model, Weibull model, and joint modeling approach for longitudinal and survival data. The results from joint model analysis indicate that systolic blood pressure measurement is significantly associated with survival time of hypertension patients. The results from the longitudinal sub-model reveals that alcohol use, Khat intake, smoking tobacco, stages of hypertension diseases, adherence to treatment, related diseases, and family history had statistical significant relationship with mean change in the \(\sqrt{SBP}\) measurement. Furthermore, from the survival sub-model, we found the survival probability of hypertension patients was determined by family history, stages of hypertension disease, related diseases, and smoking tobacco. The analysis suggests that there is a strong association between SBP measurement and survival time of hypertension patients. Thus we recommend aggressive work by all concerned bodies towards awareness creation about the effect of potential barriers.