BACKGROUND: Studies suggest that targeting high-risk, nonhypertensive individuals for treatment may delay hypertension onset, thereby possibly mitigating vascular complications. Risk stratification may facilitate cost-effective approaches to management. OBJECTIVE: To develop a simple risk score for predicting hypertension incidence by using measures readily obtained in the physician's office. DESIGN: Longitudinal cohort study. SETTING: Framingham Heart Study, Framingham, Massachusetts. PATIENTS: 1717 nonhypertensive white individuals 20 to 69 years of age (mean age, 42 years; 54% women), without diabetes and with both parents in the original cohort of the Framingham Heart Study, contributed 5814 person-examinations. MEASUREMENTS: Scores were developed for predicting the 1-, 2-, and 4-year risk for new-onset hypertension, and performance characteristics of the prediction algorithm were assessed by using calibration and discrimination measures. Parental hypertension was ascertained from examinations of the original cohort of the Framingham Heart Study. RESULTS: During follow-up (median time over all person-examinations, 3.8 years), 796 persons (52% women) developed new-onset hypertension. In multivariable analyses, age, sex, systolic and diastolic blood pressure, body mass index, parental hypertension, and cigarette smoking were significant predictors of hypertension. According to the risk score based on these factors, the 4-year risk for incident hypertension was classified as low (<5%) in 34% of participants, medium (5% to 10%) in 19%, and high (>10%) in 47%. The c-statistic for the prediction model was 0.788, and calibration was very good. LIMITATIONS: The risk score findings may not be generalizable to persons of nonwhite race or ethnicity or to persons with diabetes. The risk score algorithm has not been validated in an independent cohort and is based on single measurements of risk factors and blood pressure. CONCLUSION: The hypertension risk prediction score can be used to estimate an individual's absolute risk for hypertension on short-term follow-up, and it represents a simple, office-based tool that may facilitate management of high-risk individuals with prehypertension.
BACKGROUND: Studies suggest that targeting high-risk, nonhypertensive individuals for treatment may delay hypertension onset, thereby possibly mitigating vascular complications. Risk stratification may facilitate cost-effective approaches to management. OBJECTIVE: To develop a simple risk score for predicting hypertension incidence by using measures readily obtained in the physician's office. DESIGN: Longitudinal cohort study. SETTING: Framingham Heart Study, Framingham, Massachusetts. PATIENTS: 1717 nonhypertensive white individuals 20 to 69 years of age (mean age, 42 years; 54% women), without diabetes and with both parents in the original cohort of the Framingham Heart Study, contributed 5814 person-examinations. MEASUREMENTS: Scores were developed for predicting the 1-, 2-, and 4-year risk for new-onset hypertension, and performance characteristics of the prediction algorithm were assessed by using calibration and discrimination measures. Parental hypertension was ascertained from examinations of the original cohort of the Framingham Heart Study. RESULTS: During follow-up (median time over all person-examinations, 3.8 years), 796 persons (52% women) developed new-onset hypertension. In multivariable analyses, age, sex, systolic and diastolic blood pressure, body mass index, parental hypertension, and cigarette smoking were significant predictors of hypertension. According to the risk score based on these factors, the 4-year risk for incident hypertension was classified as low (<5%) in 34% of participants, medium (5% to 10%) in 19%, and high (>10%) in 47%. The c-statistic for the prediction model was 0.788, and calibration was very good. LIMITATIONS: The risk score findings may not be generalizable to persons of nonwhite race or ethnicity or to persons with diabetes. The risk score algorithm has not been validated in an independent cohort and is based on single measurements of risk factors and blood pressure. CONCLUSION: The hypertension risk prediction score can be used to estimate an individual's absolute risk for hypertension on short-term follow-up, and it represents a simple, office-based tool that may facilitate management of high-risk individuals with prehypertension.
Authors: Jimeng Sun; Candace D McNaughton; Ping Zhang; Adam Perer; Aris Gkoulalas-Divanis; Joshua C Denny; Jacqueline Kirby; Thomas Lasko; Alexander Saip; Bradley A Malin Journal: J Am Med Inform Assoc Date: 2013-09-17 Impact factor: 4.497
Authors: Emelia J Benjamin; Michael J Blaha; Stephanie E Chiuve; Mary Cushman; Sandeep R Das; Rajat Deo; Sarah D de Ferranti; James Floyd; Myriam Fornage; Cathleen Gillespie; Carmen R Isasi; Monik C Jiménez; Lori Chaffin Jordan; Suzanne E Judd; Daniel Lackland; Judith H Lichtman; Lynda Lisabeth; Simin Liu; Chris T Longenecker; Rachel H Mackey; Kunihiro Matsushita; Dariush Mozaffarian; Michael E Mussolino; Khurram Nasir; Robert W Neumar; Latha Palaniappan; Dilip K Pandey; Ravi R Thiagarajan; Mathew J Reeves; Matthew Ritchey; Carlos J Rodriguez; Gregory A Roth; Wayne D Rosamond; Comilla Sasson; Amytis Towfighi; Connie W Tsao; Melanie B Turner; Salim S Virani; Jenifer H Voeks; Joshua Z Willey; John T Wilkins; Jason Hy Wu; Heather M Alger; Sally S Wong; Paul Muntner Journal: Circulation Date: 2017-01-25 Impact factor: 29.690
Authors: April P Carson; Cora E Lewis; David R Jacobs; Carmen A Peralta; Lyn M Steffen; Julie K Bower; Sharina D Person; Paul Muntner Journal: Hypertension Date: 2013-09-16 Impact factor: 10.190
Authors: Henry Völzke; Carsten O Schmidt; Sebastian E Baumeister; Till Ittermann; Glenn Fung; Janina Krafczyk-Korth; Wolfgang Hoffmann; Matthias Schwab; Henriette E Meyer zu Schwabedissen; Marcus Dörr; Stephan B Felix; Wolfgang Lieb; Heyo K Kroemer Journal: Nat Rev Cardiol Date: 2013-03-26 Impact factor: 32.419
Authors: Charlotte Andersson; Rene Quiroz; Danielle Enserro; Martin G Larson; Naomi M Hamburg; Joseph A Vita; Daniel Levy; Emelia J Benjamin; Gary F Mitchell; Ramachandran S Vasan Journal: Hypertension Date: 2016-07-25 Impact factor: 10.190