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Disease entities, mixed multi‐normal distributions, and the role of the hyperkinetic state in the pathogenesis of hypertension
Author(s) -
Schork Nicholas J.,
Weder Alan B.,
Schork M. Anthony,
Bassett David R.,
Julius Stevo
Publication year - 1990
Publication title -
statistics in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.996
H-Index - 183
eISSN - 1097-0258
pISSN - 0277-6715
DOI - 10.1002/sim.4780090313
Subject(s) - univariate , pathogenesis , disease , multivariate statistics , population , normal distribution , medicine , multivariate normal distribution , multivariate analysis , distribution (mathematics) , cardiology , statistics , mathematics , mathematical analysis , environmental health
This paper concerns the theory and relevance of finite mixtures of univariate and multivariate normal distributions in medical research and suggests that multivariate normal mixture analysis, hitherto not extensively explored, is an appealing approach to the investigation of etiologically obscure, multifactorial diseases such as hypertension. We elaborate a statistical strategy to resolve and test for a normal mixture distribution in a seemingly heterogenous population actually comprising homogenous subpopulations. We use this strategy to validate the hypothesis that in the population at large there is a subgroup of individuals with the characteristic of a hyperkinetic circulatory state, defined as the association of an elevated cardiac index or heart rate with high blood pressure. This subgroup may have implications for the pathogenesis of hypertension. We discuss directions and implications for future research into the pathogenesis of hypertension.