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使用列线图模型预测中国高血压患者的非勺型血压模式。

Prediction of non-dipper blood pressure pattern in Chinese patients with hypertension using a nomogram model.

作者信息

Sun Dandan, Li Zhihua, Xu Guomei, Xue Jing, Wang Wenqing, Yin Ping, Wang Meijuan, Shang Miaomiao, Guo Li, Cui Qian, Dai Yuchuan, Zhang Ran, Wang Xueting, Song Dongmei

机构信息

Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining, China.

出版信息

Front Physiol. 2024 Jul 24;15:1309212. doi: 10.3389/fphys.2024.1309212. eCollection 2024.

Abstract

Non-dipper blood pressure has been shown to affect cardiovascular outcomes and cognitive function in patients with hypertension. Although some studies have explored the influencing factors of non-dipper blood pressure, there is still relatively little research on constructing a prediction model. This study aimed to develop and validate a simple and practical nomogram prediction model and explore relevant elements that could affect the dipper blood pressure relationship in patients with hypertension. A convenient sampling method was used to select 356 inpatients with hypertension who visited the Affiliated Hospital of Jining Medical College from January 2022 to September 2022. All patients were randomly assigned to the training cohort (75%, n = 267) and the validation cohort (25%, n = 89). Univariate and multivariate logistic regression were utilized to identify influencing factors. The nomogram was developed and evaluated based on the receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC), and decision curve analyses. The optimal cutoff values for the prevalence of dipper blood pressure were estimated. The nomogram was established using six variables, including age, sex, hemoglobin (Hb), estimated glomerular filtration rate (eGFR), ejection fraction (EF), and heart rate. The AUC was 0.860 in the training cohort. The cutoff values for optimally predicting the prevalence of dipper blood pressure were 41.50 years, 151.00 g/L, 117.53 mL/min/1.73 m, 64.50%, and 75 beats per minute for age, Hb, eGFR, ejection fraction, and heart rate, respectively. In summary, our nomogram can be used as a simple, plausible, affordable, and widely implementable tool to predict the blood pressure pattern of Chinese patients with hypertension.

摘要

已有研究表明,非勺型血压会影响高血压患者的心血管结局和认知功能。尽管一些研究探讨了非勺型血压的影响因素,但构建预测模型的研究仍相对较少。本研究旨在开发并验证一种简单实用的列线图预测模型,并探索可能影响高血压患者勺型血压关系的相关因素。采用便利抽样方法,选取了2022年1月至2022年9月在济宁医学院附属医院就诊的356例高血压住院患者。所有患者被随机分为训练队列(75%,n = 267)和验证队列(25%,n = 89)。采用单因素和多因素逻辑回归来识别影响因素。基于受试者工作特征(ROC)曲线、ROC曲线下面积(AUC)和决策曲线分析来开发和评估列线图。估计了勺型血压患病率的最佳截断值。使用年龄、性别、血红蛋白(Hb)、估算肾小球滤过率(eGFR)、射血分数(EF)和心率6个变量建立列线图。训练队列中的AUC为0.860。年龄、Hb、eGFR、射血分数和心率预测勺型血压患病率的最佳截断值分别为41.50岁、151.00 g/L、117.53 mL/min/1.73 m²、64.50%和75次/分钟。总之,我们的列线图可作为一种简单、合理、经济且可广泛应用的工具,用于预测中国高血压患者的血压模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d0/11303159/bdb4458baa94/fphys-15-1309212-g001.jpg

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