Why the study?
Joint trajectories of blood pressure and heart rate and their association with early cardiac remodeling, particularly relative wall thickness changes, remain incompletely characterized.
Are distinct joint trajectories of blood pressure and heart rate associated with changes in relative wall thickness in hypertensive patients?
Are distinct joint trajectories of blood pressure and heart rate associated with changes in relative wall thickness in hypertensive patients?
Sustained optimal blood pressure control, glycemic management, and regular sleep patterns are associated with reduced hypertensive cardiac remodeling as measured by relative wall thickness.
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Sustained optimal BP control was associated with reduced RWT; hypothesis-generating for joint BP-HR trajectories in hypertensive remodeling.
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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Zhang et al. (2025) studied this question.
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