Key result
Multi-level intervention linked to improved 24-month SBP in three of four trajectory groups among Hispanic patients.
Why the study?
Little attention has been given to characterizing change patterns in hypertension outcomes among participants of health interventions with multiple chronic conditions.
What are the longitudinal trajectories of systolic blood pressure in Hispanic individuals with comorbid diabetes and hypertension enrolled in a multi-level healthcare intervention?
Cohort (n=2,476)
What are the longitudinal trajectories of systolic blood pressure in Hispanic individuals with comorbid diabetes and hypertension enrolled in a multi-level healthcare intervention?
Group-based trajectory modeling identified four distinct systolic blood pressure response patterns to a multi-level intervention in a high-risk Hispanic population, highlighting the need for tailored approaches based on patient heterogeneity.
Answers are grounded in this paper and cite their sources.
Highlights SBP response heterogeneity in Hispanic patients with diabetes and hypertension; hypothesis-generating for tailored interventions.
Objective: Individuals with diabetes and hypertension represent a high-risk population with poor prognosis and high healthcare costs. Clinicians recognize the complexities of treating patients with multiple chronic conditions; however, the research literature shows little attention to characterizing change patterns in hypertension outcomes for participants of health interventions. The aim of this study was to characterize individual-level longitudinal trajectories of heterogeneity in blood pressure among a Hispanic population with uncontrolled type II diabetes and hypertension enrolled in a multi-level intervention. Methods: This study was implemented along the US-Mexico border. Using blood pressure results collected longitudinally between 2013 and 2020 from 2476 participants with diabetes and high blood pressure at baseline, we conducted group-based trajectory modeling to identify latent groups for systolic blood pressure (SBP). We evaluated participant engagement characteristics and other individual-level characteristics and elucidated how these factors were associated with group membership. Results: We identified four distinct SBP trajectory groups. Three groups demonstrated improvement, two of which had clinically significant changes in SBP that were maintained through 24 months. One group was resistant to SBP improvements despite the intervention. While all groups maintained higher than normal SBP levels, the group characteristics elucidate factors that contribute to improvement or lack thereof. Conclusion: Understanding SBP trajectories in the context of population heterogeneity can inform tailoring approaches undertaken by interventions. These findings inform approaches for clinics to more effectively match screening of non-medical drivers of health to individual patient needs.
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Lee et al. (2025) conducted a cohort in uncontrolled type II diabetes and hypertension (n=2,476). multi-level intervention was evaluated on systolic blood pressure (SBP) trajectories. A multi-level intervention for Hispanic patients with diabetes and hypertension yielded four distinct systolic blood pressure trajectory groups, three of which demonstrated improvement over 24 months.
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