Department of Cardiology, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Sichuan, China.
J Clin Hypertens (Greenwich). 2021 Aug;23(8):1556-1566. doi: 10.1111/jch.14267. Epub 2021 May 11.
Cardiac involvement is an important cause of morbidity and mortality in patients with idiopathic inflammatory myopathies (IIMs). Hypertension, an important cardiovascular risk factor for the general population, has a crucial role in heart involvement. However, few studies have focused on the hypertension associated with IIMs. This study aimed to develop and assess the prediction model for incident hypertension in patients with IIMs. A retrospective cohort study was performed on 362 patients with IIMs, of whom 54 (14.9%) were given a diagnosis of new-onset hypertension from January 2008 to December 2018. The predictors of hypertension in IIMs were selected by least absolute shrinkage and selection operator (LASSO) regression, multivariable logistic regression, and clinically relevance, and then these predictors were used to draw the nomogram. Discrimination, calibration and clinical usefulness of the model were evaluated using the C-index, calibration plot, and decision curve analysis, respectively. The predicting model was validated by the bootstrapping validation. The nomogram mainly included predictors such as age, diabetes mellitus, triglyceride, low-density lipoprotein-cholesterol (LDL-C), antinuclear antibodies (ANA), and smoking. This prediction model demonstrated good discrimination with a C-index of 0.754 (95%CI, 0.684 to 0.824) and good calibration. The C-index of internal validation was 0.728, and decision curve analysis demonstrated that this nomogram was clinically useful. Clinicians can use this prediction model to assess the risk of hypertension in IIMs patients, and early preventive measures should be taken to reduce the incidence of hypertension in high-risk patients.
心脏受累是特发性炎性肌病（IIM）患者发病率和死亡率的重要原因。高血压是普通人群重要的心血管危险因素，在心脏受累中起着关键作用。然而，很少有研究关注与 IIM 相关的高血压。本研究旨在开发和评估 IIM 患者新发高血压的预测模型。对 2008 年 1 月至 2018 年 12 月期间诊断为新发性高血压的 362 例 IIM 患者进行了回顾性队列研究。采用最小绝对收缩和选择算子（LASSO）回归、多变量逻辑回归和临床相关性选择 IIM 中高血压的预测因素，然后使用这些预测因素绘制列线图。通过 C 指数、校准图和决策曲线分析分别评估模型的区分度、校准和临床实用性。通过自举验证对预测模型进行验证。该列线图主要包括年龄、糖尿病、甘油三酯、低密度脂蛋白胆固醇（LDL-C）、抗核抗体（ANA）和吸烟等预测因素。该预测模型具有良好的区分度，C 指数为 0.754（95%CI：0.684 至 0.824），校准良好。内部验证的 C 指数为 0.728，决策曲线分析表明该列线图具有临床实用性。临床医生可以使用该预测模型评估 IIM 患者发生高血压的风险，并对高危患者采取早期预防措施以降低高血压的发生率。
