Evaluating Hypertension Onset and Progression in Type 2 Diabetes patients using Markov Multistate Model

Puja Goswami, International Institute for Population Sciences (IIPS)
T R Dilip, IIPS
Anjali Kulkarni, Homi Bhabha National Institute
Yogesh Shejul, Bhabha Atomic Research Centre

The study investigates the differences in hypertension patterns between individuals with and without Type 2 Diabetes using data from the CHSS-IIPS project. It employs Kaplan-Meier survival analysis, log-rank tests, and Markov Multistate Models to analyze transition patterns, and logistic regression to assess hypertension risk in diabetes patients. Findings show that non-diabetic men have a higher hypertension risk than women, but this gender disparity disappears among diabetics, with both genders facing equal risk. A direct correlation exists between age and hypertension onset in both groups, with diabetic individuals, especially women, developing hypertension earlier than non-diabetics. The Markov chain model indicates minor differences in the transition rates from normal to hypertensive states, with a higher probability of transitioning to hypertension within ten years for diabetics. Additionally, there is a greater difference in the total time before hypertension onset between genders in non-diabetics compared to diabetics. The study concludes that aging, male gender, higher HbA1c levels, longer diabetes duration, and comorbidities like dyslipidaemia and thyroid disorders significantly increase the risk of hypertension in diabetes patients.

Keywords: Health and Morbidity

See extended abstract.