The Jichi Genki model, incorporating eating rate, uric acid, proteinuria, and BMI by age, accurately predicted incident hypertension (derivation C-statistic 0.885; 95% CI 0.865-0.903).
Cohort (n=63,495)
A new risk-prediction model incorporating lifestyle factors, uric acid, and eating rate accurately predicts the 3-year absolute risk of new-onset hypertension in normotensive individuals.
Effect estimate: C-statistic 0.885 (95% CI 0.865-0.903)
No integrated risk assessment tools that include lifestyle factors and uric acid have been developed. In accordance with the Industrial Safety and Health Law in Japan, a follow‐up examination of 63 495 normotensive individuals (mean age 42.8 years) who underwent a health checkup in 2010 was conducted every year for 5 years. The primary endpoint was new‐onset hypertension (systolic blood pressure SBP /diastolic blood pressure DBP ≥ 140/90 mm Hg and/or the initiation of antihypertensive medications with self‐reported hypertension). During the mean 3.4 years of follow‐up, 7402 participants (11.7%) developed hypertension. The prediction model included age, sex, body mass index ( BMI ), SBP , DBP , low‐density lipoprotein cholesterol, uric acid, proteinuria, current smoking, alcohol intake, eating rate, DBP by age, and BMI by age at baseline and was created by using Cox proportional hazards models to calculate 3‐year absolute risks. The derivation analysis confirmed that the model performed well both with respect to discrimination and calibration (n = 63 495; C‐statistic = 0.885, 95% confidence interval CI , 0.865‐0.903; χ 2 statistic = 13.6, degree of freedom df = 7). In the external validation analysis, moreover, the model performed well both in its discrimination and calibration characteristics (n = 14 168; C‐statistic = 0.846; 95% CI , 0.775‐0.905; χ 2 statistic = 8.7, df = 7). Adding LDL cholesterol, uric acid, proteinuria, alcohol intake, eating rate, and BMI by age to the base model yielded a significantly higher C‐statistic, net reclassification improvement ( NRI ), and integrated discrimination improvement, especially NRI non‐event ( NRI = 0.127, 95% CI = 0.100‐0.152; NRI non‐event = 0.108, 95% CI = 0.102‐0.117). In conclusion, a highly precise model with good performance was developed for predicting incident hypertension using the new parameters of eating rate, uric acid, proteinuria, and BMI by age.
Kanegae et al. (Sat,) conducted a cohort in New-onset hypertension (n=63,495). Jichi Genki hypertension prediction model vs. Base model was evaluated on New-onset hypertension (SBP/DBP ≥ 140/90 mm Hg and/or the initiation of antihypertensive medications with self-reported hypertension) (C-statistic 0.885, 95% CI 0.865-0.903). The Jichi Genki model, incorporating eating rate, uric acid, proteinuria, and BMI by age, accurately predicted incident hypertension (derivation C-statistic 0.885; 95% CI 0.865-0.903).