Time-to-event modeling of hypertension reveals the nonexistence of true controls

Abstract

Given a lifetime risk of ~90% by the ninth decade of life, it is unknown if there are true controls for hypertension in epidemiological and genetic studies. Here, we compared Bayesian logistic and time-to-event approaches to modeling hypertension. The median age at hypertension was approximately a decade earlier in African Americans than in European Americans or Mexican Americans. The probability of being free of hypertension at 85 years of age in African Americans was less than half that in European Americans or Mexican Americans. In all groups, baseline hazard rates increased until nearly 60 years of age and then decreased but did not reach zero. Taken together, modeling of the baseline hazard function of hypertension suggests that there are no true controls and that controls in logistic regression are cases with a late age of onset.

The unique association of posttraumatic stress disorder with hypertension among veterans: A replication of Kibler et al. (2009) using Bayesian estimation and data from the United States-Veteran Microbiome Project.

“…As such, hypertension might have preceded PTSD or MDD onset. However, as in Kibler et al (2009), the median age of the present sample (47 years) tended to be younger than the median age of hypertension development in the general population (48 to 57 years; Shriner et al, 2020). This increases the likelihood that PTSD preceded the development of hypertension and represents a modifiable risk factor.…”