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| A prediction model for hypertension risk among residents aged 18 to 79 years |
| GONG Haiying, XUE Fengyu, LIU Xiaofen, XING Ruiting, MIAO Yuyang, ZHAO Yao
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| Fangshan District Center for Disease Control and Prevention, Beijing 102488, China |
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Abstract Objective To construct a hypertension risk prediction model for residents aged 18-79 years, so as to provide an assessment tool for early screening and prevention of hypertension in high-risk groups. Methods The permanent residents aged 18-79 years from 6 townships (streets) in Fangshan District of Beijing Municipality were selected as the study subjects using a multi-stage stratified random sampling method from March to June 2023. Demographic information, lifestyle, body mass index (BMI), blood pressure, fasting blood glucose, and blood lipid were collected through questionnaire survey, physical examination, and laboratory tests. Subjects were randomly divided into training and validation sets at a 7∶3 ratio. The logistic regression model was used to screen the risk factors of hypertension, and a hypertension risk prediction nomogram was constructed. Receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis were used to verify the discrimination, fit, and clinical application value of the model. Results A total of 4 438 subjects were included, including 2 365 males (53.29%) and 2 073 females (46.71%), with a mean age of (44.99±14.90) years. The prevalence of hypertension was 35.29% (1 566 cases), and the standardized prevalence was 24.74%. The logistic regression model screened out 9 influencing factors of hypertension. The nomogram was established as ln[p/ (1-p)]= -2.873 + 0.935×40-<50 years + 1.463×50-<60 years + 1.908×60-<70 years + 2.346×70-79 years + 0.298×male-0.675×college degree or above + 0.384×smoking + 0.227×drinking + 0.572×overweight + 1.449×obesity + 0.557×heart rate ≥80 beats/min + 0.428×diabetes + 0.484×dyslipidemia. The area under the ROC curve of the validation set was 0.821 (95%CI: 0.798-0.843), and the calibration curve results showed that the calibration curve fitted the actual curve well. Decision curve analysis showed that the threshold probability was in the range of 0.10 to 0.70, and the model had good predictive value and clinical application value. Conclusion The nomogram based on age, gender, educational level, smoking, drinking, body mass index, heart rate, diabetes, and dyslipidemia can be used to predict the risk of hypertension among residents aged 18-79 years.
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Received: 25 April 2025
Revised: 13 August 2025
Published: 23 October 2025
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[1] 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].China J Epidemiol,2021,42(10):1780-1789.(in Chinese) [2] NESI J.The impact of social media on youth mental health:challenges and opportunities[J].N C Med J,2020,81(2):116-121. [3] ZHOU B,PEREL P,MENSAH G A,et al.Global epidemiology,health burden and effective interventions for elevated blood pressure and hypertension[J].Nat Rev Cardiol,2021,18(11):785-802. [4] WANG L X,WANG Y W,HAN T,et al.Development and validation of a model to predict the risk of hypertension using anthropometric indicators in the Chinese population:a retrospective cohort study[J].Am J Transl Res,2023,15(3):2207-2219. [5] MILLS K T,STEFANESCU A,HE J.The global epidemiology of hypertension[J].Nat Rev Nephrol,2020,16(4):223-237. [6] 于宁,张梅,张笑,等.中国中老年居民高血压、糖尿病和血脂异常共病现状及影响因素研究[J].中华流行病学杂志,2023,44(2):196-204. YU N,ZHANG M,ZHANG X,et al.Study on the status and influencing factors of comorbidity of hypertension,diabetes,and dyslipidemia among middle-aged and elderly Chinese adults[J].China J Epidemiol,2023,44(2):196-204.(in Chinese) [7] 中国肥胖问题工作组.中国成人超重和肥胖症预防与控制指南(节录)[J].营养学报,2004,26(1):1-4. Chinese Obesity Task Force.Guidelines for prevention and control of overweight and obesity among adults in China(excerpt)[J].Acta Nutr Sin,2004,26(1):1-4.(in Chinese) [8] 中国高血压防治指南修订委员会,中国高血压联盟,中华医学会心血管病学分会,等.中国高血压防治指南(2018年修订版)[J].中国心血管杂志,2019,24(1):24-56. Writing Group of 2018 Chinese Guidelines for the Management of Hypertension,Chinese Hypertension League,Chinese Society of Cardiology,et al.2018 Chinese guidelines for the management of hypertension[J].Chin J Cardiovasc Rehabil Med,2019,24(1):24-56.(in Chinese) [9] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志,2021,13(4):315-409. Chinese Diabetes Society.Guideline for the prevention and treatment of type 2 diabetes mellitus in China(2020 edition)[J].Chin J Diabetes Mellit,2021,13(4):315-409.(in Chinese) [10] 中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中华心血管病杂志,2016,44(10):833-853. Joint committee issued Chinese guideline for the management of dyslipidemia in adults.2016 Chinese guideline for the management of dyslipidemia in adults[J].Chin J Cardiol,2016,44(10):833-853.(in Chinese) [11] 马丽媛,王增武,樊静,等.《中国心血管健康与疾病报告2021》关于中国高血压流行和防治现状[J].中国全科医学,2022,25(30):3715-3720. MA L Y,WANG Z W,FAN J,et al.Epidemiology and management of hypertension in China:an analysis using data from the Annual Report on Cardiovascular Health and Diseases in China(2021)[J].Chin Gen Pract,2022,25(30):3715-3720.(in Chinese) [12] 王淳秀,吴晓光,刘宏军,等.北京市2013—2014年15岁及以上居民高血压患病率、知晓率、治疗率和控制率调查[J].中华流行病学杂志,2018,39(2):179-183. WANG C X,WU X G,LIU H J,et al.Prevalence,awareness,treatment and control of hypertension in population older than 15 years of age in Beijing,2013-2014[J].Chin J Epidemiol,2018,39(2):179-183.(in Chinese) [13] 周晓云,石红梅,汪静.北京市东城区成人高血压患病率、知晓率、治疗率、控制率分析[J].中国医药科学,2024,14(8):143-147,198. ZHOU X Y,SHI H M,WANG J.Analysis of the prevalence,awareness,treatment,and control rates of adult hypertension in Dongcheng District,Beijing[J].China Med Pharm,2024,14(8):143-147,198.(in Chinese) [14] HARVEY A,MONTEZANO A C,TOUYZ R M.Vascular biology of ageing-implications in hypertension[J].J Mol Cell Cardiol,2015,83:112-121. [15] 童绥俊,周军,陈磊,等.高血压患者心血管疾病风险及其性别差异分析[J].心肺血管病杂志,2022,41(1):18-24,88. TONG S J,ZHOU J,CHEN L,et al.Cardiovascular disease risk and its gender differences in hypertension patients[J].J Cardiovasc Pulm Dis,2022,41(1):18-24,88.(in Chinese) [16] 王梦琴,柴荟琳,郭宇燕,等.山西省农村居民高血压防治知识、态度、行为调查[J].预防医学,2023,35(7):563-569. WANG M Q,CHAI H L,GUO Y Y,et al.Knowledge,attitude,and practice of hypertension prevention and control among rural residents in Shanxi Province[J].China Prev Med J,2023,35(7):563-569.(in Chinese) [17] LARSSON S C,MASON A M,BÄCK M,et al.Genetic predisposition to smoking in relation to 14 cardiovascular diseases[J].Eur Heart J,2020,41(35):3304-3310. [18] 关云琦,梁明斌,何青芳,等.浙江省成年居民饮酒与高血压的关联研究[J].预防医学,2021,33(9):877-883. GUAN Y Q,LIANG M B,HE Q F,et al.Association between alcohol consumption and hypertension in adults of Zhejiang Province[J].China Prev Med J,2021,33(9):877-883.(in Chinese) [19] KIM M S,KIM W J,KHERA A V,et al.Association between adiposity and cardiovascular outcomes:an umbrella review and meta-analysis of observational and Mendelian randomization studies[J].Eur Heart J,2021,42(34):3388-3403. [20] WANG A X,LIU X X,GUO X H,et al.Resting heart rate and risk of hypertension:results of the Kailuan cohort study[J].J Hypertens,2014,32(8):1600-1605. [21] 沈益妹,章奇,朱新凤,等.湖州市血压控制未达标高血压患者慢性病共病及影响因素分析[J].预防医学,2023,35(6):541-545,550. SHEN Y M,ZHANG Q,ZHU X F,et al.Prevalence and influencing factors of comorbidity of chronic diseases among hypertensive patients with uncontrolled blood pressure in Huzhou City[J].China Prev Med J,2023,35(6):541-545,550.(in Chinese) |
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