Key result
A cardiovascular risk assessment model incorporating nine risk factors and baseline blood pressure achieved a c-index of 0.732 for predicting cardiovascular events in hypertensive patients.
Why the study?
Many assessments predict cardiovascular risk in the general population, but their applicability in patients with hypertension required further evaluation.
Cohort (n=4,763)
Effect estimate: c-index 0.732
A newly developed risk assessment model incorporating nine clinical factors and baseline blood pressure showed moderate predictive ability for cardiovascular events in a rural Chinese hypertensive population.
May support hypertension-specific risk models; leaves open external validation and outcome impact before clinical adoption.
Many assessments have been used to predict cardiovascular risks in the general population, but their applicability in patients with hypertension needs to be further evaluated. In the current study, a cardiovascular risk assessment model was constructed in a hypertensive population. This prospective cohort study was conducted with cardiovascular examinations in rural northeast China in 2012 and 2013, and followed up to collect cardiovascular events in 2015 and 2018. Data were derived from 4763 hypertensive patients who were free of cardiovascular disease (CVD) at baseline and completed follow-up. After lasso regression was used to screen for risk factors of CVD at baseline, a multivariate Cox regression risk model was established and a nomogram was developed. The model was validated using an independent test set (one third of data not used for model building). Among 4763 patients, 354 (7.43%) had a cardiovascular event during a median follow-up of 4.66 years. Nine risk factors were screened by lasso regression, including sex, age, current smoking, body mass index (BMI), history of transient ischemic attack (TIA), family history of hypertension, family history of stroke, physical labor intensity, and high low-density lipoprotein cholesterol (LDL-C). The c-index of the CVD model was 0.707, and that of an updated model with baseline blood pressure was 0.732. In the validated cohort the respective c-indexes were 0.665 and 0.714. An assessment model of CVD risk was established in a hypertensive population which may provide an original prevention strategy for hypertensive populations in rural China, and further reduce the CVD burden.
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Ouyang et al. (2021) conducted a cohort in hypertension (n=4,763). Cardiovascular risk assessment model was evaluated on cardiovascular events (c-index 0.732). A cardiovascular risk assessment model incorporating nine risk factors and baseline blood pressure achieved a c-index of 0.732 for predicting cardiovascular events in hypertensive patients.
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