Department of Cardiology, First Hospital of China Medical University.
Department of Medical Record Management, First Hospital of China Medical University.
Circ J. 2022 Aug 25;86(9):1464-1473. doi: 10.1253/circj.CJ-22-0016. Epub 2022 May 13.
This study aimed to establish a clinically useful nomogram to evaluate the probability of hypertension onset in the Chinese population.
A prospective cohort study was conducted in 2012-2013 and followed up in 2015 to identify new-onset hypertension in 4,123 participants. The dataset was divided into development (n=2,748) and verification (n=1,375) cohorts. After screening risk factors by lasso regression, a multivariate Cox regression risk model and nomogram were established. Among the 4,123 participants, 818 (19.8%) developed hypertension. The model identified 10 risk factors: age, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, high pulse rate, history of diabetes, family history of hypertension and stroke, intake frequency of bean products, and intensity of physical labor. The C-indices of the model in the development and validation cohorts were 0.744 and 0.768, respectively. After the inclusion of serum calcium and magnesium concentrations, the C-indices in the development and validation cohorts were 0.764 and 0.791, respectively, with areas under the curve for the updated model of 0.907 and 0.917, respectively. The calibration curve showed that the nomogram accurately predicted the probability of hypertension. The updated nomogram was clinically beneficial across thresholds of 10-60%.
The newly developed nomogram has good predictive ability and may effectively assess hypertension risk in high-risk rural areas in China.
本研究旨在建立一个可用于评估中国人群高血压发病概率的临床实用诺莫图。
在 2012 年至 2013 年期间进行了一项前瞻性队列研究，并在 2015 年进行了随访，以确定 4123 名参与者中新发高血压的情况。该数据集分为开发（n=2748）和验证（n=1375）队列。通过套索回归筛选出风险因素后，建立了多变量 Cox 回归风险模型和诺莫图。在 4123 名参与者中，818 名（19.8%）发生了高血压。该模型确定了 10 个风险因素：年龄、腰臀比、收缩压、舒张压、高脉搏率、糖尿病史、高血压和中风家族史、豆制品摄入频率以及体力劳动强度。该模型在开发和验证队列中的 C 指数分别为 0.744 和 0.768。纳入血清钙和镁浓度后，开发和验证队列中的 C 指数分别为 0.764 和 0.791，更新模型的曲线下面积分别为 0.907 和 0.917。校准曲线表明，该诺莫图准确预测了高血压的概率。该更新的诺莫图在 10%至 60%的阈值范围内具有临床益处。
新开发的诺莫图具有良好的预测能力，可能有效地评估中国农村高危地区的高血压风险。
