Department of Cardiology, The Affiliated Hospital of Southwest Jiaotong University/The Third People's Hospital of Chengdu, Chengdu, China.
College of Medicine, Southwest Jiaotong University, Chengdu, China.
J Hum Hypertens. 2022 Nov;36(11):996-1002. doi: 10.1038/s41371-021-00603-7. Epub 2021 Sep 24.
Cardiovascular disease (CVD) is one of the main causes of death in primary Sjögren' s syndrome (pSS) patients, while hypertension is considered an independent risk factor for CVD in pSS patients and its prevalence is increased compared with the general population. In order to identify risk factors of hypertension in patients with pSS, this study included 293 pSS patients admitted in the Third People's Hospital of Chengdu from April 2011 to August 2020 and 195 pSS patients admitted in Sichuan Provincial People's Hospital from January 2011 to June 2018. The multiple logistic regression was used to screen risk factors and nomogram was drawn based on regression coefficients. Then C-index and calibration plot were used to estimate its discrimination and calibration, respectively. Compared with pSS patients without hypertension, those with hypertension were older, higher in blood pressure, longer in duration of pSS, and had higher rates of smoking, xerophthalmia, xerostomia, previous use of botanicals, NSAIDs, and statins. Moreover, they were more likely to have pulmonary interstitial fibrosis and had higher levels of serum lipids and renal function indicators (all P < 0.05). Finally, a nomogram based on four significant factors (age, duration of pSS, LDL-c, and anti-SSA antibody) was constructed. Its' C-index is 0.812 (95% CI: 0.754-0.870), and it shows a good calibration. C-index value of 0.721 and good calibration still could be reached in external verification. Clinicians can use it in pSS population for early detection of hypertension and if necessary, early preventive measures could be taken to reduce its occurrence.
心血管疾病（CVD）是原发性干燥综合征（pSS）患者死亡的主要原因之一，而高血压被认为是 pSS 患者 CVD 的独立危险因素，其患病率高于普通人群。为了确定 pSS 患者高血压的危险因素，本研究纳入了 2011 年 4 月至 2020 年 8 月期间在成都市第三人民医院就诊的 293 例 pSS 患者和 2011 年 1 月至 2018 年 6 月期间在四川省人民医院就诊的 195 例 pSS 患者。采用多因素逻辑回归筛选危险因素，并根据回归系数绘制列线图。然后分别采用 C 指数和校准图评估其判别能力和校准度。与无高血压的 pSS 患者相比，高血压患者年龄更大，血压更高，pSS 病程更长，吸烟、干眼症、口干症、既往使用植物药、非甾体抗炎药和他汀类药物的比例更高，且更易并发肺间质纤维化，血脂和肾功能指标水平更高（均 P < 0.05）。最终，构建了一个基于 4 个显著因素（年龄、pSS 病程、LDL-c 和抗-SSA 抗体）的列线图。其 C 指数为 0.812（95%CI：0.754-0.870），具有良好的校准度。外部验证中，C 指数值为 0.721，仍具有较好的校准度。临床医生可以在 pSS 人群中使用该列线图，早期发现高血压，如果有必要，及早采取预防措施，降低其发生。
