Incident hypertension and its prediction model in a prospective northern urban Han Chinese cohort study

Chen, Y; Wang, C; Liu, Y; Yuan, Zhongshang; Zhang, W; Li, X; Yang, Yafei; Sun, Xiaoru; Xue, Fuzhong; Zhang, C

doi:10.1038/jhh.2016.23

Cited by 32 publications

(29 citation statements)

References 32 publications

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“…Despite this, in agreement with a previous study [25], we did not find sex to be an independent risk factor for incident hypertension. Some previous studies have reported the male sex [8,31] and others, the female sex [22,32] to be a risk factor for hypertension.…”

Section: Discussionmentioning

confidence: 95%

Sex-Specific Incidence Rates and Risk Factors for Hypertension During 13 Years of Follow-up: The Tehran Lipid and Glucose Study

Asgari

Moazzeni

Azizi

et al. 2020

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Background: Hypertension, with a prevalence of 25.6% is a serious public health concern in Iran. Objective: To investigate the population-based incidence of hypertension and its potential risk factors in Tehranian adults during a median follow-up of 13.1 years. Methods: A total of 6,533 non-hypertensive participants (women = 3,639), aged ≥20 years participated in the study. Crude and age-standardized incidence rates per 1000 person-years were calculated for each sex, separately. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for all potential risk factors. Results: The crude and age-standardized incidence rates (95% CI) of hypertension per 1000 person-years were 29.7 (27.8-31.6) and 34.9 (32.5-37.4) among men and 25.8 (24.3-27.3) and 38.7 (35.5-42.0) among women, respectively. The incidence rate of hypertension in younger age groups was higher among men. However, after the 4 th decade, the incidence rate was higher among women. Significant interactions of sex with age groups, body mass index categories, marital status, hypertriglyceridemia and glycemic categories were found in multivariable analyses (all p-values < 0.05). In the multivariable model, the risk in both sexes was found to be significantly associated with older age, obesity, and normal or high normal blood pressure (BP). Moreover, factors such as being overweight [HR: 1.20 (1.00-1.44)], former smoking [2.15 (1.52-3.04)], hypertriglyceridemia [1.23 (1.06-1.43)] and pre-diabetes status [1.19 (1.02-1.39)] were significant predictors of incident hypertension among women. Central obesity was found to be a significant predictor among men [1.26 (1.03-1.54)]. The optimism-corrected Harrell's C index (95% CI) in the categorical adjusted model was 0.75 (0.74-0.79) among men and 0.75 (0.74-0.76) among women. Conclusion: In the Tehranian population, nearly 2.7% of total participants (3% of men and 2.6% of women) develop hypertension each year. Obesity and high BP levels are the main modifiable risk factors in both sexes. Hypertriglyceridemia, prediabetes and former smoking are risk factors for hypertension among women.

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Section: Discussionmentioning

confidence: 95%

Sex-Specific Incidence Rates and Risk Factors for Hypertension During 13 Years of Follow-up: The Tehran Lipid and Glucose Study

Asgari

Moazzeni

Azizi

et al. 2020

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“…Our initial literature search resulted in 7332 citations; only 26 articles were selected, reporting 48 prediction models. Table 1 shows the characteristics of these 26 studies, of which 5 were conducted in the US[ 7 – 11 ], 5 in Europe[ 12 – 16 ], 7 in China[ 17 – 23 ], 4 in Korea[ 24 – 27 ], 2 in Japan[ 28 , 29 ], 2 in Iran[ 30 , 31 ], and 1 in India[ 32 ]. Among them, only 1 study was carried out in women alone[ 9 ].…”

Section: Resultsmentioning

confidence: 99%

Recent development of risk-prediction models for incident hypertension: An updated systematic review

et al. 2017

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BackgroundHypertension is a leading global health threat and a major cardiovascular disease. Since clinical interventions are effective in delaying the disease progression from prehypertension to hypertension, diagnostic prediction models to identify patient populations at high risk for hypertension are imperative.MethodsBoth PubMed and Embase databases were searched for eligible reports of either prediction models or risk scores of hypertension. The study data were collected, including risk factors, statistic methods, characteristics of study design and participants, performance measurement, etc.ResultsFrom the searched literature, 26 studies reporting 48 prediction models were selected. Among them, 20 reports studied the established models using traditional risk factors, such as body mass index (BMI), age, smoking, blood pressure (BP) level, parental history of hypertension, and biochemical factors, whereas 6 reports used genetic risk score (GRS) as the prediction factor. AUC ranged from 0.64 to 0.97, and C-statistic ranged from 60% to 90%.ConclusionsThe traditional models are still the predominant risk prediction models for hypertension, but recently, more models have begun to incorporate genetic factors as part of their model predictors. However, these genetic predictors need to be well selected. The current reported models have acceptable to good discrimination and calibration ability, but whether the models can be applied in clinical practice still needs more validation and adjustment.

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“…In China, Zhang et al 26 analyzed data from 26,496 hypertensive patients and they set up a hypertension synthetic predictor by weighing the risk of hypertension for each factor to build a risk assessment matrix with an AUC of 0.755 for men and 0.800 for women. Both Chen et al 27 and Qi et al 28 analyzed the state of hypertension in northern China and established predicted models from different perspectives. Chen et al established models using traditional risk factors, including BMI, age, SBP, DBP, serum glucose level and alcohol consumption for both women and men, while current smoking, neutrophil granulocyte, and total cholesterol only for women (AUC = 0.753), gamma-glutamyltransferaseonly for men (AUC = 0.761).…”

Section: Discussionmentioning

confidence: 99%

A novel predicted model for hypertension based on a large cross-sectional study

Ren

Rao

et al. 2020

Sci Rep

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Hypertension is a global public health issue and leading risk for death and disability. It is urgent to search novel methods predicting hypertension. Herein, we chose 73158 samples of physical examiners in central China from June 2008 to June 2018. After strict exclusion processes, 33570 participants with hypertension and 35410 healthy controls were included. We randomly chose 70% samples as the train set and the remaining 30% as the test set. Clinical parameters including age, gender, height, weight, body mass index, triglyceride, total cholesterol, low-density lipoprotein, blood urea nitrogen, uric acid, and creatinine were significantly increased, while high-density lipoprotein was decreased in the hypertension group versus controls. Nine optimal markers were identified by a logistic regression model, and achieved AUC value of 76.52% in the train set and 75.81% in the test set for hypertension. In conclusions, this study is the first to establish predicted models for hypertension using the logistic regression model in Central China, which provide risk factors and novel prediction method to predict and prevent hypertension. Hypertension which is a global public health issue is a leading risk for death and disability 1. It exacerbates the burden of kidney failure, stroke, and heart disease, as well as premature mortality and disability. The number of people with hypertension worldwide increased by 400 million in 2008, and about 40% of adults over the age of 25 are diagnosed with hypertension. The risk of death associated with systolic blood pressure increases significantly with increasing systolic blood pressure 2. Hypertension ranks first among all modifiable causes of cerebrovascular disease (CVD) and is the second preventable cause of death in the United States 3. By 2030, the number of global CVD-related deaths will exceed 23.3 million 4. It's reported by the World Health Organization (WHO) that global CAD cause approximately 17 million deaths each year 5 , of which approximately 9.4 million die from complications of hypertension 6. Hypertension accounts for at least 51% death of stroke and 45% death of heart diseases 5. In 2010, hypertension has been the leading cause of disability-adjusted life years and death. Then, the disability-adjusted life year caused by CAD was 366 million in 2017. Among them, the disability-adjusted life year caused by hypertensive heart disease was 16.5 million 7. The prevalence of hypertension in China was high (46.4%) in 2012-2015 according to the 2017 American College of Cardiology/American Heart Association guidelines 8. However, the awareness, control and treatment of hypertension are unsatisfactory 8. Thus, it is important and urgent to search a new method predicting hypertension. The increased prevalence of hypertension is due to behavioral risk factors, aging and population growth, such as persistent stress, being overweight, lack of physical exercise, harmful consumption of alcohol and unhealthy diet 9. The harmful effects of hypertension are complicated, including the in...

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Incident hypertension and its prediction model in a prospective northern urban Han Chinese cohort study

Cited by 32 publications

References 32 publications

Sex-Specific Incidence Rates and Risk Factors for Hypertension During 13 Years of Follow-up: The Tehran Lipid and Glucose Study

Sex-Specific Incidence Rates and Risk Factors for Hypertension During 13 Years of Follow-up: The Tehran Lipid and Glucose Study

Recent development of risk-prediction models for incident hypertension: An updated systematic review

A novel predicted model for hypertension based on a large cross-sectional study

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