# Multimorbiditeit bij hypertensie volgt gesegregeerde tijdpatronen met hart- en herseninfarct als kern

*geplaatst 2026-10-31 · Hypertensie · JMIR public health and surveillance · doi 10.2196/93217 · https://hartvaat.nl/2026/10/23/multimorbiditeit-bij-hypertensie-volgt-gesegregeerde-tijdpatronen-met-hart-en-he/*

Een retrospectieve cohortstudie onder 34.099 ziekenhuispatiënten met hypertensie in drie Chinese plattelandsregio’s toont dat de progressie van bijkomende aandoeningen gestructureerde, maar heterogene tijdpatronen volgt. De netwerkanalyse onthult een kerncomplex rondom hypertensie, atherosclerotische hartziekte en herseninfarct, waarbij type 2-diabetes fungeert als brug tussen cardiovasculaire en multisystemische clusters. Progressie verschilt per geslacht, leeftijd en verzekeringsstatus, wat pleit voor risicogestuurde en lokaal afgestemde preventie- en zorgpaden.

## English: Temporal Patterns of Multimorbidity Progression Among Inpatients With a Recorded Hypertension Diagnosis Across Three Counties in Rural Henan, China: Retrospective Cohort Study Using Temporal Network Analysis.

A retrospective cohort study of 34,099 inpatients with hypertension in rural China reveals structured but heterogeneous temporal patterns of multimorbidity progression. Network analysis identifies a dense core linking hypertension, atherosclerotic heart disease, and cerebral infarction, with type 2 diabetes bridging cardiovascular and multisystem disease clusters. Progression pathways vary by sex, age, and insurance status, underscoring the need for risk-stratified and locally tailored chronic disease management strategies.

## Abstract (original, from the publication)

BACKGROUND: Hypertension is a key driver of multimorbidity; however, its role in shaping dynamic disease progression, especially in rural populations, remains underexplored. OBJECTIVE: This study aimed to characterize temporal patterns of multimorbidity progression among inpatients with a recorded hypertension diagnosis and to examine whether these patterns differed by sex, age, insurance type, and county. METHODS: We analyzed electronic health record data from 34,099 inpatients with a recorded hypertension diagnosis across 3 rural counties in Henan, China (2019-2023), constructing a temporal comorbidity network of 250 disease nodes and 1512 disease transitions. Statistical validation was performed using bootstrap resampling, case-dropping, and permutation tests. Subgroup analyses were conducted by sex, age, insurance type, and county. RESULTS: The temporal comorbidity network revealed a densely interconnected core involving hypertension, atherosclerotic heart disease, and cerebral infarction, with type 2 diabetes occupying a bridging position between cardiovascular and multisystem disease clusters. The ordering of dominant recorded pathways differed by sex (earlier coronary involvement among female inpatients vs more direct progression to stroke among male inpatients), was more complex in inpatients older than 70 years of age, and was more diffuse among those covered by urban-rural resident insurance compared with urban employee insurance. CONCLUSIONS: Multimorbidity among inpatients with recorded hypertension followed structured and heterogeneous temporal patterns that differed by sex, age, insurance type, and county. Cardiovascular and cerebrovascular conditions formed the principal recorded progression pathways, while type 2 diabetes connected cardiovascular pathways with broader multisystem complications. These findings support further evaluation of risk-stratified and locally adapted approaches to chronic disease prevention and longitudinal care.

Auteurs: Yifei Wang, Yanna Mao, Xi Wang, Rongmei Liu, Manman Cui, Ruihua Feng

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Bron: JMIR public health and surveillance, https://doi.org/10.2196/93217. Bijgewerkt 2026-10-24T01:34:30Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.