Group-Based Multitrajectory Modeling Analysis of Joint Trajectories of Blood Pressure and Heart Rate and Their Association With Relative Change in Relative Wall Thickness in Patients With Hypertension: Community-Based Longitudinal Cohort Study.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Hypertension (n=213). Intervention: Joint trajectory group 2 (normal BP and high HR) vs. Joint trajectory group 4 (stage 2 hypertension, high HR). Primary outcome: Relative change in relative wall thickness (Δ RWT) over 6 months (b = -0.059, 95% CI -0.112 to -0.007, p=0.03).

Q: What does this research mean for the field?

Joint trajectories of blood pressure and heart rate are marginally associated with relative changes in relative wall thickness in patients with hypertension. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Qi Pan; Nanxiang Zhang; Shuo Yang; Chonglong Ding; Jianan Yin; Yi Fei; Xinyan Zou; Yongjun Zheng; Xiang Huang; Jiezhen Feng; Hai Lin; Jinxin Zhang

doi:10.2196/87091

September 9, 2026

Group-Based Multitrajectory Modeling Analysis of Joint Trajectories of Blood Pressure and Heart Rate and Their Association With Relative Change in Relative Wall Thickness in Patients With Hypertension: Community-Based Longitudinal Cohort Study.

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Key result

Normal BP with high heart rate is linked to reduced relative wall thickness over 6 months.

b = -0.059
95% CI -0.112 to -0.007
P=0.03
n=213

Figures

Why the study?

The joint trajectories of longitudinal BP and HR, and their association with early hypertensive cardiac remodeling, remain incompletely characterized.

Does a joint trajectory of normal blood pressure and high heart rate improve relative wall thickness in patients with hypertension?

Key Points

To identify joint longitudinal trajectories of blood pressure and heart rate using ambulatory blood pressure monitoring and determine their association with relative changes in relative wall thickness among patients with hypertension.
A longitudinal cohort study was conducted among 213 patients with hypertension aged 35 to 80 years across 3 community health centers in Zhongshan City, Guangdong Province, China, between November 2022 and January 2025.
Blood pressure and heart rate were evaluated via ambulatory blood pressure monitoring across 4 visits over 9 months (baseline, 3, 6, and 9 months), and group-based multitrajectory modeling was used to identify joint hemodynamic patterns.
Multiple linear regression and sensitivity analyses adjusting for age and sex, as well as complete-case analysis, were conducted to evaluate factors associated with relative change in relative wall thickness.
The model identified 4 joint trajectory groups; trajectory group 2 (normal blood pressure and high heart rate) was independently associated with a reduction in relative wall thickness change (b = -0.059, 95% CI -0.112 to -0.007; fully adjusted sensitivity P = .04).
Medicated diabetes mellitus was associated with a decrease in relative wall thickness change (b = -0.067, 95% CI -0.116 to -0.018), whereas waking before 7 AM was associated with an increase (b = 0.045, 95% CI 0.007 to 0.083).
In complete-case analysis (n = 196), the association for trajectory group 2 attenuated to marginal significance (P = .06) due to reduced statistical power, while waking before 7 AM (P = .004) and antidiabetic medication use (P = .01) remained significant.

Study Design

Type

Cohort (n=213)

Multicenter

Yes

Structured PICO

Does a joint trajectory of normal blood pressure and high heart rate improve relative wall thickness in patients with hypertension?

P

Population

213 community-dwelling adults with hypertension, median age 57, 48.4% female, followed for 9 months to assess joint trajectories of blood pressure and heart rate.

E

Exposure

Joint trajectory group 2 (normal BP and high HR: 128/77 mm Hg, 80 bpm)

C

Comparator

Joint trajectory group 4 (stage 2 hypertension, high HR: 142/89 mm Hg, 84 bpm) as reference

O

Outcome

Relative change in relative wall thickness (Δ RWT) over 6 months (between 3 and 9 months follow-up)surrogate

Main Result

Mean Difference: -0.059 (95% CI -0.112–-0.007)

p-value: p=0.03

A joint trajectory of normal blood pressure and high heart rate is associated with improved left ventricular geometry in hypertensive patients, highlighting the need for combined BP and HR assessment.

Limitations

Selection bias from a single community
Specific roles of different classes of antidiabetic medications were not explored
Follow-up period was relatively short
Echocardiographic measurements were obtained at 3-month and 9-month follow-ups rather than baseline
Shortened 6-month observation window restricted detectable magnitude of changes
Low utilization rate of β-blockers
Modest sample size

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Implication

Does not warrant practice changes in hypertension; leaves open whether joint BP-HR trajectories influence LV remodeling.

Abstract

Background: Ambulatory blood pressure monitoring objectively assesses circadian hemodynamic rhythms. However, the joint trajectories of longitudinal blood pressure (BP) and heart rate (HR), and their association with early hypertensive cardiac remodeling, remain incompletely characterized. Objective: RWT). Methods: RWT. Sensitivity analyses were conducted by adjusting for age and sex, and by using complete-case data. Conclusions: RWT.

Discussion

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Cite This Study

Pan et al. (2026) conducted a cohort in Hypertension (n=213). Joint trajectory group 2 (normal BP and high HR) vs. Joint trajectory group 4 (stage 2 hypertension, high HR) was evaluated on Relative change in relative wall thickness (Δ RWT) over 6 months (b = -0.059, 95% CI -0.112 to -0.007, p=0.03). A joint trajectory of normal blood pressure and high heart rate was independently associated with a reduction in relative wall thickness over 6 months (b = -0.059, p=0.03).

Group-Based Multitrajectory Modeling Analysis of Joint Trajectories of Blood Pressure and Heart Rate and Their Association With Relative Change in Relative Wall Thickness in Patients With Hypertension: Community-Based Longitudinal Cohort Study.

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Group-Based Multitrajectory Modeling Analysis of Joint Trajectories of Blood Pressure and Heart Rate and Their Association With Relative Change in Relative Wall Thickness in Patients With Hypertension: Community-Based Longitudinal Cohort Study.

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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