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| Establishment of a hypertension risk assessment model among middle-aged and elderly populations based on the basic publichealth service program |
| LIN Tianxiang, QIU Yinwei, WANG Wei, ZHAO Yanrong, JIANG Xuewen, YANG Qing
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| Department of Public Health Surveillance and Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China |
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Abstract Objective To establish a hypertension risk assessment model among the middle-aged and elderly populations based on residents' electronic healthcare records of the basic public health service program, so as to provide insights into prevention of hypertension. Methods Demographic features and physical examinations were collected among residents at ages of 40 years and older from residents' electronic healthcare records of the basic public health service program in a county of Zhejiang Province from 2019 to 2020. The risk factors of hypertension were identified using a multivariable logistic regression model, and the odds ratio (OR) for each risk factor was transformed into approximate relative risk (RR), which was included in the formula for calculation of the disease risk proposed by Harvard School of Public Health to create a hypertension risk assessment model. The predictive value of the model was evaluated using a receiver operator characteristic (ROC) curve. Results Totally 7 275 subjects were enrolled, with a mean age of (66.15±7.91) years, and the participants included 3 189 males and 4 086 females, with a male-to-female ratio of 0.78∶1. There were 190 cases with new-onset hypertension (2.61%). Multivariable logistic regression analysis revealed that overweight, obesity, central obesity, borderline high triacylglycerol (TG), elevated TG, abnormal fasting plasma glucose (FPG), prehypertension and family history of hypertension were included in the hypertension risk assessment model, with approximate RR values of 1.66, 1.96, 1.54, 1.17, 1.64, 1.45, 1.69 and 1.11. The area under the ROC curve (AUC) of the model was 0.678 (95%CI: 0.641-0.715, P<0.001), and the optimal positive cut-off was 0.899. The model predicted 139 subjects with RR>0.899 for hypertension, with a sensitivity of 73.16% and specificity of 55.79%. Conclusions The hypertension risk assessment model created in this study is feasible to predict the RR for developing hypertension among the middle-aged and elderly populations, which has a predictive value in healthcare management.
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Received: 30 March 2022
Revised: 13 June 2022
Published: 18 August 2022
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[1] QI Y,HAN X,ZHAO D,et al.Long-term cardiovascular risk associated with stage 1 hypertension defined by the 2017 ACC/AHA Hypertension Guideline[J].J Am Coll Cardiol,2018,72(11):1201-1210.
[2] 张梅,吴静,张笑,等.2018年中国成年居民高血压患病与控制状况研究[J].中华流行病学杂志,2021,42(10):1780-1789.
ZHANG M,WU J,ZHANG X,et al.Prevalence and control of hypertension in adults in China,2018[J].Chin J Epidemiol,2021,42(10):1780-1789.
[3] LU J,LU Y,WANG X,et al.Prevalence,awareness,treatment,and control of hypertension in China:data from 1.7 million adults in a population-based screening study(China PEACE Million Persons Project)[J].Lancet,2017,390(10112):2549-2558.
[4] KIM D J,ROCKHILL B,COLDITZ G A.Validation of the Harvard Cancer Risk Index:a prediction tool for individual cancer risk[J].J Clin Epidemiol,2004,57(4):332-340.
[5] 中华人民共和国国家心血管病中心国家基本公共卫生服务项目基层高血压管理办公室,国家基层高血压管理专家委员会.国家基层高血压防治管理指南2020版[J].中国循环杂志,2021,36(3):209-220.
The National Essential Public Health Service Program Office for Management of Hypertension in Primary Health Care,National Center for Cardiovascular Diseases,National Committee on Hypertension in Primary Health Care.National clinical practice guidelines on the management of hypertension in primary health care in China(2020)[J].Chin Circul J,2021,36(3):209-220.
[6] 中华人民共和国卫生部.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006:3-8.
Ministry of Health of the People's Republic of China.Guidelines for the prevention and control of overweight and obesity in adults in China[M].Beijing:People's Medical Press,2006:3-8.
[7] 诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-953.
ZHU J R,GAO R L,ZHAO S P,et al.2016 Chinese guideline for the management of dyslipidemia in adults[J].Chin Circul J,2016,31(10):937-953.
[8] ZHANG J,YU K F.What's the relative risk?A method of correcting the odds ratio in cohort studies of common outcomes[J].JAMA,1998,280(19):1690-1691.
[9] 宋花玲,贺佳,黄品贤,等.ROC曲线下面积估计的参数法与非参数法的应用研究[J].第二军医大学学报,2006,27(7):726-728.
SONG H L,HE J,HUANG P X,et al.Application of parametric method and non-parametric method in estimation of area under ROC curve[J].Acad J Second Mil Med Univ,2006,27(7):726-728.
[10] COLDITZ G A,ATWOOD K A,EMMONS K,et al.Harvard report on cancer prevention volume 4:Harvard Cancer Risk Index.Risk Index Working Group,Harvard Center for Cancer Prevention[J].Cancer Causes Control,2000,11(6):477-488.
[11] 吴海云,潘平,何耀,等.我国成年人糖尿病发病风险评估方法[J].中华健康管理学杂志,2007,1(2):95-98.
WU H Y,PAN P,HE Y,et al.A risk model for prediction of diabetes in Chinese adults[J].Chin J Health Manag,2007,1(2):95-98.
[12] 王文慧. 基于哈佛癌症风险指数的脑卒中风险评估方法及应用研究[D].乌鲁木齐:新疆医科大学,2020.
WANG W H.Stroke risk assessment method based on the harvard cancer risk index and applied research[D].Urumqi:Xinjiang Medical University,2020.
[13] 潘沙沙,赵焱,孙静.老年人群阿尔茨海默病风险评估模型的构建[J].中华现代护理杂志,2019,25(24):3076-3080.
PAN S S,ZHAO Y,SUN J.Establishment of Alzheimer's disease risk assessment model for elderly population[J].Chin J Mod Nurs,2019,25(24):3076-3080.
[14] 李庆奎. 天津市城乡居民心脑血管病患病率调查及高血压发病风险评估[D].天津:天津医科大学,2017.
LI Q K.Prevalence of cardio-cerebro-vascular disease and hypertension risk assessment among the urban and suburb residents in Tianjin[D].Tianjin:Tianjin Medical University,2017.
[15] 李娜,伍亚舟,易东.基于疾病风险指数的重庆市社区居民脑卒中发病风险评估方法[J].第三军医大学学报,2010,32(20):2216-2219.
LI N,WU Y Z,YI D.An algorithm based on Disease Risk Index for predicting individual stroke risk in community residents in Chongqing[J].Acta Acad Medicinae Militaris Tertiae,2010,32(20):2216-2219.
[16] PARIKH N I,PENCINA M J,WANG T J,et al.A risk score for predicting near-term incidence of hypertension:the Framingham Heart Study[J].Ann Intern Med,2008,148(2):102-110.
[17] WANG B,LIU Y,SUN X,et al.Prediction model and assessment of probability of incident hypertension:the Rural Chinese Cohort Study[J].J Hum Hypertens,2021,35(1):74-84.
[18] 李文丽,苏银霞,诸葛瑾慧,等.新源县哈萨克族人群主要慢性病的影响因素分析[J].预防医学,2021,33(4):398-403.
LI W L,SU Y X,ZHUGE J H,et al.Prevalence and influencing factors of chronic diseases among Kazakh ethnic group in Xinyuan County[J].Prev Med,2021,33(4):398-403.
[19] 李杰,顾月.成人高血压和高血压前期影响因素研究[J].预防医学,2017,29(12):1207-1212.
LI J,GU Y.A study on risk factors of hypertension and prehypertension among adults in Xishan District[J].Prev Med,2017,29(12):1207-1212.
[20] WANG J,SUN W,WELLS G A,et al.Differences in prevalence of hypertension and associated risk factors in urban and rural residents of the northeastern region of the People's Republic of China:a cross-sectional study[J/OL].PLoS One,2018,13(4)[2022-06-13].https://doi.org/10.1371/journal.pone.0195340. |
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