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盐敏感性高血压青年左心室肥厚的危险因素及预测模型。

Risk factors and a predictive model for left ventricular hypertrophy in young adults with salt-sensitive hypertension.

机构信息

Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

J Clin Hypertens (Greenwich). 2024 Aug;26(8):933-944. doi: 10.1111/jch.14863. Epub 2024 Jun 28.

Abstract

Salt-sensitive hypertension is common among individuals with essential hypertension, and the prevalence of left ventricular hypertrophy (LVH) has increased. However, data from early identification of the risk of developing LVH in young adults with salt-sensitive hypertension are lacking. Thus, the present study aimed to design a nomogram for predicting the risk of developing LVH in young adults with salt-sensitive hypertension. A retrospective analysis of 580 patients with salt-sensitive hypertension was conducted. The training set consisted of 70% (n = 406) of the patients, while the validation set consisted of the remaining 30% (n = 174). Based on multivariate analysis of the training set, predictors for LVH were extracted to develop a nomogram. Discrimination curves, calibration curves, and clinical utility were employed to assess the predictive performance of the nomogram. The final simplified nomogram model included age, sex, office systolic blood pressure, duration of hypertension, abdominal obesity, triglyceride-glucose index, and estimated glomerular filtration rate (eGFR). In the training set, the model demonstrated moderate discrimination, as indicated by an area under the receiver operating characteristic (ROC) curve of 0.863 (95% confidence interval: 0.831-0.894). The calibration curve exhibited good agreement between the predicted and actual probabilities of LVH in the training set. Additionally, the validation set further confirmed the reliability of the prediction nomogram. In conclusions, the simplified nomogram, which consists of seven routine clinical variables, has shown good performance and clinical utility in identifying young adults with salt-sensitive hypertension who are at high risk of LVH at an early stage.

摘要

盐敏感性高血压在原发性高血压患者中较为常见,左心室肥厚(LVH)的患病率也有所增加。然而,对于早期识别盐敏感性高血压年轻患者发生 LVH 的风险,相关数据较为缺乏。因此,本研究旨在设计一个预测盐敏感性高血压年轻患者发生 LVH 风险的列线图。本研究对 580 例盐敏感性高血压患者进行了回顾性分析。其中训练集占 70%(n=406),验证集占 30%(n=174)。基于训练集的多变量分析,提取出 LVH 的预测因子,以开发列线图。采用判别曲线、校准曲线和临床实用性来评估列线图的预测性能。最终简化的列线图模型包括年龄、性别、诊室收缩压、高血压病程、腹型肥胖、甘油三酯-葡萄糖指数和估算肾小球滤过率(eGFR)。在训练集中,该模型显示出中等的判别能力,其受试者工作特征(ROC)曲线下面积为 0.863(95%置信区间:0.831-0.894)。校准曲线显示出训练集中预测与实际 LVH 概率之间的良好一致性。此外,验证集进一步证实了预测列线图的可靠性。总之,该简化列线图由七个常规临床变量组成,在识别盐敏感性高血压年轻患者中具有良好的性能和临床实用性,可早期发现 LVH 风险较高的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7bf/11301447/a7ede312a1fb/JCH-26-933-g004.jpg

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