Document Detail


Prediction of incident hypertension risk in women with currently normal blood pressure.
MedLine Citation:
PMID:  19375556     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We examined whether a hypertension risk prediction model based on clinical characteristics and blood biomarkers might improve on risk prediction based on current blood pressure alone.
METHODS: A prospective cohort of 14,822 normotensive women aged 45 years and older were followed over 8 years beginning in 1992 for the development of hypertension. Among a randomly selected two-thirds sample (N=9427), hypertension prediction models were developed using 52 potential predictors and compared with a model based on blood pressure alone. Each prediction model was validated in the remaining one third (N=5395).
RESULTS: In the development cohort, the best prediction model for incident hypertension included age, blood pressure, ethnicity, body mass index, total grain intake, apolipoprotein B, lipoprotein(a), and C-reactive protein (Bayes Information Criteria [BIC]=8788). Although this model was superior to a model based on blood pressure alone (BIC=8957), it was only marginally better than a simplified model including age, blood pressure, ethnicity, and body mass index (BIC=8820). In the validation cohort, the simplified model demonstrated adequate calibration, a c-index similar to that of the best model (0.703 vs 0.705), and when compared with the model based on blood pressure alone, reclassified 1499 participants to hypertension risk categories that proved to be closer to observed risk in all but one instance.
CONCLUSION: In this prospective cohort of initially normotensive women, a model based on readily available clinical information predicted incident hypertension better than a model based on blood pressure alone.
Authors:
Nina P Paynter; Nancy R Cook; Brendan M Everett; Howard D Sesso; Julie E Buring; Paul M Ridker
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of medicine     Volume:  122     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-20     Completed Date:  2009-05-07     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  464-71     Citation Subset:  AIM; IM    
Affiliation:
The Center for Cardiovascular Disease Prevention and the Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Mass. 02215, USA. npaynter@partners.org
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / physiology*
Female
Follow-Up Studies
Humans
Hypertension / epidemiology*,  physiopathology
Incidence
Logistic Models
Middle Aged
Prognosis
Prospective Studies
Risk Assessment / methods*
Risk Factors
Time Factors
United Arab Emirates / epidemiology
Grant Support
ID/Acronym/Agency:
CA47988/CA/NCI NIH HHS; HL43851/HL/NHLBI NIH HHS; R01 CA047988/CA/NCI NIH HHS; R01 CA047988-09/CA/NCI NIH HHS; R01 CA047988-10/CA/NCI NIH HHS; R01 CA047988-11/CA/NCI NIH HHS; R01 CA047988-12/CA/NCI NIH HHS; R01 CA047988-13/CA/NCI NIH HHS; R01 CA047988-14/CA/NCI NIH HHS; R01 CA047988-15/CA/NCI NIH HHS; R01 CA047988-16/CA/NCI NIH HHS; R01 CA047988-17/CA/NCI NIH HHS; R01 CA047988-18/CA/NCI NIH HHS; R01 HL043851/HL/NHLBI NIH HHS; R01 HL043851-09/HL/NHLBI NIH HHS; R01 HL043851-10/HL/NHLBI NIH HHS
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