Fig. 1

Structure of the simulation model. A Decision tree. B Structure of the Markov model. C Structure of the Stay (no acute complications) module. D Structure of the acute complications module. TreeAge Pro Healthcare software was used to create this simulation model. The blue square indicates the decision node; M in the purple circle indicates the Markov node; the green circle indicates the chance node; L in the green circle indicates the logic node; and the red triangle indicates the terminal node. The terminal condition of _stage = 600 denotes that the maximum cycle length would be 600 times. Given that one cycle is equal to one month, 600 iterations means that the time horizon was set to 50 years (600 months), or a lifetime. We set three health statuses: stay (acute complication-free status), acute complication, or death. The occurrence of acute complications or death rates varies according to age, home systolic blood pressure level, and the latest acute complication history. Additionally, acute complication status includes four hypertension-related complications: coronary artery disease, stroke, heart failure, and atrial fibrillation