Hemodynaomics: A Deviation-Based Representation of Cardiovascular Physiology for Mechanism-Guided Hypertension Therapy: From Population-Based Thresholds to Personalized Physiological Balance

Hemodynaomics: A Deviation-Based Representation of Cardiovascular Physiology for Mechanism-Guided Hypertension Therapy: From Population-Based Thresholds to Personalized Physiological Balance | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Method Article Hemodynaomics: A Deviation-Based Representation of Cardiovascular Physiology for Mechanism-Guided Hypertension Therapy: From Population-Based Thresholds to Personalized Physiological Balance Zheng J Ma This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8990162/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract Background Hypertension arises from integrated abnormalities in cardiac function, vascular resistance, arterial properties, and volume status. Yet current management remains largely guided by population-based blood pressure thresholds and clinical surrogates rather than direct individual-level physiological comparison. Objectives To describe Hemodynaomics, an individualized, deviation-based framework for representing cardiovascular physiology, and to summarize randomized clinical evidence supporting its use in mechanism-informed antihypertensive therapy. Methods The Hemodynaomics framework uses individualized reference models derived from noninvasive hemodynamic data in 116,851 generally healthy Chinese adults to estimate expected values for seven key parameters (SBP, DBP, HR, CI, AS, SVRI, TBR). Measurements are expressed as standardized deviations from these individualized references, placing heterogeneous physiological variables on a common scale for comparison. Clinical support was drawn from three randomized trials (total n = 484) comparing Hemodynaomics-guided therapy with standard care. Results In these trials, Hemodynaomics-guided therapy consistently produced greater blood pressure reduction than standard care across office, home, and ambulatory settings, without evidence of greater medication burden. The observed pattern is consistent with more structured prioritization of dominant physiological abnormalities. Conclusions Hemodynaomics provides an individualized framework to normalize and interpret hemodynamic data. It translates multidimensional hemodynamic measurements into a common scale that can support clinical decision-making. This framework moves treatment beyond reliance on indirect clinical surrogates and provides a practical way to view hypertension care as restoring each patient’s physiological balance. Cardiac & Cardiovascular Systems Physiology Personalized Medicine Artificial Intelligence and Machine Learning Hemodynaomics Hypertension Hemodynamic profiling Deviation-based hemodynamic representation Individualized reference Mechanism-guided therapy Impedance cardiography Full Text Additional Declarations The authors declare potential competing interests as follows: The author reports intellectual property related to the methods described in this manuscript. The author is affiliated with BLH Medical Technologies, Inc., which is developing technologies related to the described framework. No other competing interests are declared. Supplementary Files SupplementaryS1Table.docx Supplementary Table S1. Selected clinical surrogates in contemporary hypertension guidance and their implicit physiological rationale SupplementaryS2Case.docx Supplementary Case S2. Hemodynaomics map redirected therapy away from empiric diuretic intensification in resistant hypertension Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8990162","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Method Article","associatedPublications":[],"authors":[{"id":618445802,"identity":"c603ccea-6e6a-4db8-9e73-ee5db0c1fd62","order_by":0,"name":"Zheng J Ma","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAvElEQVRIiWNgGAWjYJACAwYGmzoDiRzzzx9I0JKWbCCRV8YsQYJFhxM3SOR/Y+YhRq1u+/EHBR93nAfakrsNqMVOTreBgBazMwkJhjPP3K4zkH+7/TEPQ7Kx2QFCWg4kHDDmbbsNs+VA4jaCWs4/bABqOQf0S44ZkVpuJDMAtRwgScszBsOZbclAhwG1SBgQ45fz6c8MPrbZ1dnPAEVlhZ0cQS1AwGaAYBvgVoYMmB8Qp24UjIJRMApGLAAAyOtEjyAXJacAAAAASUVORK5CYII=","orcid":"https://orcid.org/0009-0001-5114-6507","institution":"BLH Medical Technologies, Inc","correspondingAuthor":true,"prefix":"","firstName":"Zheng","middleName":"J","lastName":"Ma","suffix":""}],"badges":[],"createdAt":"2026-02-27 16:29:23","currentVersionCode":2,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8990162/v2","doiUrl":"https://doi.org/10.21203/rs.3.rs-8990162/v2","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106724299,"identity":"4bf42cfc-88f1-487f-a6c4-245d5a8c07c5","added_by":"auto","created_at":"2026-04-12 18:27:19","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":655510,"visible":true,"origin":"","legend":"","description":"","filename":"HemodynamicProfilingv3.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8990162/v2_covered_c8a06521-945c-41a9-a850-723fa3446a0c.pdf"},{"id":106360009,"identity":"397609a4-9b01-4f2c-83ff-d2f7ebb85e70","added_by":"auto","created_at":"2026-04-07 19:59:36","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":30227,"visible":true,"origin":"","legend":"\u003cp\u003eSupplementary Table S1. Selected clinical surrogates in contemporary hypertension guidance and their implicit physiological rationale\u003c/p\u003e","description":"","filename":"SupplementaryS1Table.docx","url":"https://assets-eu.researchsquare.com/files/rs-8990162/v2/388493e20a72a4b4684aceea.docx"},{"id":106360010,"identity":"c3b03d15-31b2-44cb-8cc2-8c51e7f765ae","added_by":"auto","created_at":"2026-04-07 19:59:36","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":66027,"visible":true,"origin":"","legend":"\u003cp\u003eSupplementary Case S2. Hemodynaomics map redirected therapy away from empiric diuretic intensification in resistant hypertension\u003c/p\u003e","description":"","filename":"SupplementaryS2Case.docx","url":"https://assets-eu.researchsquare.com/files/rs-8990162/v2/8bd70a355041d806a23f9170.docx"}],"financialInterests":"The authors declare potential competing interests as follows: The author reports intellectual property related to the methods described in this manuscript. The author is affiliated with BLH Medical Technologies, Inc., which is developing technologies related to the described framework. No other competing interests are declared.\n\n","formattedTitle":"\u003cp\u003eHemodynaomics: A Deviation-Based Representation of Cardiovascular Physiology for Mechanism-Guided Hypertension Therapy: From Population-Based Thresholds to Personalized Physiological Balance\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"BLH Medical","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Hemodynaomics, Hypertension, Hemodynamic profiling, Deviation-based hemodynamic representation, Individualized reference, Mechanism-guided therapy, Impedance cardiography","lastPublishedDoi":"10.21203/rs.3.rs-8990162/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8990162/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eHypertension arises from integrated abnormalities in cardiac function, vascular resistance, arterial properties, and volume status. Yet current management remains largely guided by population-based blood pressure thresholds and clinical surrogates rather than direct individual-level physiological comparison.\u003c/p\u003e\u003ch2\u003eObjectives\u003c/h2\u003e \u003cp\u003eTo describe Hemodynaomics, an individualized, deviation-based framework for representing cardiovascular physiology, and to summarize randomized clinical evidence supporting its use in mechanism-informed antihypertensive therapy.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe Hemodynaomics framework uses individualized reference models derived from noninvasive hemodynamic data in 116,851 generally healthy Chinese adults to estimate expected values for seven key parameters (SBP, DBP, HR, CI, AS, SVRI, TBR). Measurements are expressed as standardized deviations from these individualized references, placing heterogeneous physiological variables on a common scale for comparison. Clinical support was drawn from three randomized trials (total n\u0026thinsp;=\u0026thinsp;484) comparing Hemodynaomics-guided therapy with standard care.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eIn these trials, Hemodynaomics-guided therapy consistently produced greater blood pressure reduction than standard care across office, home, and ambulatory settings, without evidence of greater medication burden. The observed pattern is consistent with more structured prioritization of dominant physiological abnormalities.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eHemodynaomics provides an individualized framework to normalize and interpret hemodynamic data. It translates multidimensional hemodynamic measurements into a common scale that can support clinical decision-making. This framework moves treatment beyond reliance on indirect clinical surrogates and provides a practical way to view hypertension care as restoring each patient\u0026rsquo;s physiological balance.\u003c/p\u003e","manuscriptTitle":"Hemodynaomics: A Deviation-Based Representation of Cardiovascular Physiology for Mechanism-Guided Hypertension Therapy: From Population-Based Thresholds to Personalized Physiological Balance","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2026-04-07 19:59:28","doi":"10.21203/rs.3.rs-8990162/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2026-03-03 13:56:54","doi":"10.21203/rs.3.rs-8990162/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"82215d64-7c8f-42f3-bc84-12e91934c3fd","owner":[],"postedDate":"April 7th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":65971230,"name":"Cardiac \u0026 Cardiovascular Systems"},{"id":65971231,"name":"Physiology"},{"id":65971232,"name":"Personalized Medicine"},{"id":65971233,"name":"Artificial Intelligence and Machine Learning"}],"tags":[],"updatedAt":"2026-04-08T22:25:46+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-07 19:59:28","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-8990162","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8990162","identity":"rs-8990162","version":["v2"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}