Development of a risk prediction model for incident hypertension in a working-age Japanese male population

Abstract

The aim of this study was to develop a risk prediction model for incident hypertension in a Japanese male population. Study participants included 15,025 nonhypertensive Japanese male workers (mean age, 38.8±8.9 years) who underwent an annual medical checkup at a company. The participants were followed-up for a median of 4.0 years to determine new-onset hypertension, defined as a systolic blood pressure (BP) ⩾140 mm Hg, a diastolic BP ⩾90 mm Hg, or the initiation of antihypertensive medication. Participants were divided into the following two cohorts for subsequent analyses: the derivation cohort (n=12,020, 80% of the study population) and the validation cohort (n=3005, the remaining 20% of the study population). In the derivation cohort, a multivariate Cox proportional hazards model demonstrated that age, body mass index, systolic and diastolic BP, current smoking status, excessive alcohol intake and parental history of hypertension were independent predictors of incident hypertension. Using these variables, a risk prediction model was constructed to estimate the 4-year risk of incident hypertension. In the validation cohort, the risk prediction model demonstrated high discrimination ability and acceptable calibration, with a C-statistic of 0.861 (95% confidence interval 0.844, 0.877) and a modified Hosmer-Lemeshow χ2 statistic of 15.2 (P=0.085). A risk score sheet was constructed to enable the simple calculation of the approximate 4-year probability of incident hypertension. In conclusion, a practical risk prediction model for incident hypertension was successfully developed in a working-age Japanese male population.

Body mass index, abdominal adiposity, weight gain and risk of developing hypertension: a systematic review and dose–response meta‐analysis of more than 2.3 million participants

“…S1. We identified 56 prospective cohort studies , whose characteristics are presented in Table S2. One study reported results for two separate cohort studies and was regarded as two different studies .…”

“…Finally, 57 prospective cohort studies with 2,343,466 participants and 216,182 incident cases of HTN were included in meta‐analysis. Twenty studies were from the USA , 13 studies were from Europe , 20 studies were from Asia , 2 studies were from Africa , 1 study was from Mexico and 1 was from Brazil . Baseline characteristics of included studies are presented in Table S2, and reported risk estimates in relation to different categories of anthropometric measures in each study are presented in Table S3.…”

“…Finally, 57 prospective cohort studies with 2,343,466 participants and 216,182 incident cases of HTN were included in meta-analysis. Twenty studies were from the USA (36,39,46,47,50,(52)(53)(54)57,61,63,64,69,77,(81)(82)(83)(84)88,89), 13 studies were from Europe (37,45,49,56,65,71,72,(74)(75)(76)(77)79,80), 20 studies were from Asia (13,(40)(41)(42)(43)(44)55,58,59,62,(66)(67)(68)70,73,78,(85)…”

“…Fifty prospective cohort studies with 2,255,067 participants and 190,320 incident cases of HTN reported results on BMI and risk of developing HTN (13,(36)(37)(38)(39)(40)(41)(43)(44)(45)(46)(47)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(63)(64)(65)(66)(67)(68)70,71,(73)(74)(75)(76)(77)(78)(79)(80)(81)(82)(83)(84)86,87,89,90). The summary RR for a five-unit increment in BMI was 1.49 (95%CI: 1.41, 1.58), with extreme heterogeneity, I 2 = 97.4%, P heterogeneity-0.0001 (…”

Association between mean platelet volume and hypertension incidence

“…Other factors such as glucose, total cholesterol, highdensity lipoprotein cholesterol, 31 uric acid, 32 smoking, body mass index and triglycerides 33 were also selected for inclusion in the fully adjusted model that considered these factors correlated with blood pressure levels in former studies but that were not included in the list of covariates. These factors were included into the fully adjusted model but did not distinctly alter the association of elevated MPV and the increased risk of hypertension.…”