Key result
Non-laboratory risk score accurately detects hypertension in Ethiopian women with an AUROC of ~0.82.
Why the study?
Sub-Saharan Africa faces a growing hypertension epidemic, and in Ethiopia limited clinical infrastructure leaves most cases undiagnosed because standard risk models require laboratory profiles that are unavailable.
Does a non-laboratory multivariable clinical risk score accurately predict adult hypertension in non-pregnant Ethiopian women aged 15 to 49 years?
Cross-Sectional (n=12,850)
Yes
Does a non-laboratory multivariable clinical risk score accurately predict adult hypertension in non-pregnant Ethiopian women aged 15 to 49 years?
This study provides a validated, non-laboratory clinical risk score with high discrimination (AUROC 0.818) to help primary care workers in resource-limited settings like Ethiopia screen and triage non-pregnant women at high risk for hypertension.
Answers are grounded in this paper and cite their sources.
May aid hypertension screening where labs are unavailable; leaves open external validation and outcome trials before adoption.
Background Sub-Saharan Africa faces a growing hypertension epidemic. In Ethiopia, limited clinical infrastructure leaves most cases undiagnosed as standard risk models require unavailable laboratory profiles. This study developed, internally validated and translated a non-laboratory clinical risk score for hypertension among non-pregnant Ethiopian women using 2024/25 Ethiopian Demographic and Health Survey biomarker data. Methods Analyzing data from 12,850 non-pregnant women aged 15 to 49 years (80% derivation; 20% validation cohorts) hypertension was defined by elevated blood pressure or medication use. Multivariable logistic regression identified predictors converted into a point-based scoring system via Framingham scaling. Model performance followed TRIPOD guidelines using 1000 bootstrap resamples assessing discrimination via the area under the receiver operating characteristic curve, calibration via the Brier score and net benefit via Decision Curve Analysis. Results Weighted hypertension prevalence was 15.8%. Seven independent predictors were retained: age, body mass index, urban residence, household wealth, tobacco use, high parity and family history of non-communicable diseases (score range: 0 to 18). The score demonstrated excellent discrimination in both derivation (area under the receiver operating characteristic curve: 0.824) and validation cohorts (area under the receiver operating characteristic curve: 0.818) alongside strong calibration (Brier score: 0.091). At a 6-point cutoff sensitivity was 81.4% and specificity was 78.2%. Decision Curve Analysis confirmed net clinical benefit. Conclusions This validated non-laboratory clinical risk score provides a practical screening tool for Health Extension Workers and primary care nurses to effectively triage high-risk women and reduce Ethiopia's cardiovascular burden.
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Gebiru et al. (2026) conducted a cross-sectional in Hypertension (n=12,850). 7-variable non-laboratory clinical risk score (age, BMI, urban residence, household wealth, tobacco use, high parity, family history of NCDs) vs. Observed hypertension status (mean SBP >=140 mmHg, mean DBP >=90 mmHg, or antihypertensive medication use) was evaluated on Hypertension (mean SBP >= 140 mmHg, mean DBP >= 90 mmHg, or self-reported antihypertensive medication use) (95% CI 15.1%-16.5%). A 7-predictor non-laboratory risk score identified hypertension (15.8% prevalence) among non-pregnant Ethiopian women with an AUROC of 0.818, 81.4% sensitivity, and 78.2% specificity at a 6-point cutoff.
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