Date of Award

January 2014

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Haiqun Lin

Second Advisor

James Dziura


Objective: The study aimed to identify trajectories of systolic blood pressure (SBP),

diastolic blood pressure (DBP), and pulse pressure (PP) in Chinese adult workers from ages 18 to 81 years.

Methods: Analysis was conducted with a longitudinal data from Qingdao Port Health and Nutrition Examination Survey. This is a prospective study of employees of China's Qingdao Port Company that was initiated in 1999 and has been collecting annual measure of blood pressure. For our analysis, we focused on the cohort from 2000 to 2011. A group-based trajectory modeling was adopted to identify patterns of blood pressure over the lifespan. The dual model was used to jointly estimate the trajectories of two distinct, but related longitudinal outcome series.

Results: Five trajectory patterns were identified from dual trajectory model of systolic blood pressure and pulse pressure, and diastolic blood pressure and pulse pressure. Systolic blood pressure kept increasing over time whereas diastolic blood pressure gradually increased then decreased in older ages. Pulse pressure began to increase in middle age and rose more steeply subsequently. In the dual model, the posterior probability of being assigned to a distinct group for one outcome was influenced by the membership in the group of the other outcome that was modeled simultaneously. The most interesting finding was that the group membership assignment in single trajectory model remained the same in dual trajectory model only for systolic blood pressure.

Conclusion: Classifying individuals into unobserved latent trajectory groups allow us to gain a better understanding of the determinants of blood pressure patterns and lead to more personalized treatment and prevention plans among Chinese adult workers.


This is an Open Access Thesis.

Open Access

This Article is Open Access