Multimorbidity among inpatients with recorded hypertension in rural Henan followed structured and heterogeneous temporal patterns that differed by sex, age, insurance type, and county, with cardiovascular and cerebrovascular conditions forming the principal recorded progression pathways and type 2 diabetes bridging to broader multisystem complications.
The temporal comorbidity network built from inpatient records of 34,099 patients with recorded hypertension in three rural Henan counties contained 250 disease nodes and 1512 disease transitions.
The network showed a densely interconnected core of hypertension, atherosclerotic heart disease, and cerebral infarction.
Type 2 diabetes occupied a bridging position between cardiovascular disease clusters and multisystem disease clusters.
The ordering of dominant recorded disease pathways differed by sex.
Progression pathways were more complex among inpatients older than 70 years.
Pathways were more diffuse among inpatients covered by urban-rural resident insurance than among those with urban employee insurance.
Overall, multimorbidity in inpatients with recorded hypertension followed structured but heterogeneous temporal patterns across subgroups.
This study looked at hospital records from about 34,000 people with a recorded diagnosis of high blood pressure in three rural counties in Henan, China, between 2019 and 2023. The researchers mapped the order in which other diseases were recorded over time, creating a network of 250 conditions and 1512 links between them. Statistical checks were used to test that the patterns were stable. The map showed a tightly connected core of high blood pressure, heart disease caused by clogged arteries, and stroke caused by blocked blood flow in the brain. Type 2 diabetes acted as a link between these heart and blood vessel conditions and a wider set of complications affecting other body systems. The order of conditions varied: women tended to have heart-artery problems recorded earlier, while men more often went more directly to stroke. Patterns were more complex in people over 70 and more scattered among those on rural-resident insurance than urban employee insurance. This research suggests that disease progression in people with hypertension is not the same for everyone, and that prevention and long-term care may benefit from being tailored to a person's sex, age, insurance coverage, and location. Because the data come only from hospitalized patients and show the order in which diagnoses were recorded, the findings do not prove that one disease causes another and may not apply to people who are not hospitalized.
Wang Y, Mao Y, Wang X, Liu R, Cui M, Feng R. (2026). 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.. JMIR public health and surveillance. https://doi.org/10.2196/93217