Risk factors and a predictive model for left ventricular hypertrophy in young adults with salt-sensitive hypertension

IF 2.7 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Jindong Wan MD, Peijian Wang PhD, Sen Liu MD, Xinquan Wang PhD, Peng Zhou MD, Jian Yang PhD
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Abstract

Salt-sensitive hypertension is common among individuals with essential hypertension, and the prevalence of left ventricular hypertrophy (LVH) has increased. However, data from early identification of the risk of developing LVH in young adults with salt-sensitive hypertension are lacking. Thus, the present study aimed to design a nomogram for predicting the risk of developing LVH in young adults with salt-sensitive hypertension. A retrospective analysis of 580 patients with salt-sensitive hypertension was conducted. The training set consisted of 70% (n = 406) of the patients, while the validation set consisted of the remaining 30% (n = 174). Based on multivariate analysis of the training set, predictors for LVH were extracted to develop a nomogram. Discrimination curves, calibration curves, and clinical utility were employed to assess the predictive performance of the nomogram. The final simplified nomogram model included age, sex, office systolic blood pressure, duration of hypertension, abdominal obesity, triglyceride-glucose index, and estimated glomerular filtration rate (eGFR). In the training set, the model demonstrated moderate discrimination, as indicated by an area under the receiver operating characteristic (ROC) curve of 0.863 (95% confidence interval: 0.831–0.894). The calibration curve exhibited good agreement between the predicted and actual probabilities of LVH in the training set. Additionally, the validation set further confirmed the reliability of the prediction nomogram. In conclusions, the simplified nomogram, which consists of seven routine clinical variables, has shown good performance and clinical utility in identifying young adults with salt-sensitive hypertension who are at high risk of LVH at an early stage.

Abstract Image

盐敏感性高血压年轻成人左心室肥大的风险因素和预测模型。
盐敏感性高血压在原发性高血压患者中很常见,左心室肥厚(LVH)的发病率也有所上升。然而,早期识别盐敏感性高血压青壮年左心室肥厚发病风险的数据还很缺乏。因此,本研究旨在设计一种提名图,用于预测盐敏感性高血压青壮年患者罹患左心室肥厚的风险。本研究对 580 名盐敏感性高血压患者进行了回顾性分析。训练集包括 70% 的患者(n = 406),验证集包括剩余的 30%(n = 174)。在对训练集进行多变量分析的基础上,提取了 LVH 的预测因子,并绘制了提名图。采用辨别曲线、校准曲线和临床实用性来评估提名图的预测性能。最终简化的提名图模型包括年龄、性别、办公室收缩压、高血压持续时间、腹部肥胖、甘油三酯-葡萄糖指数和估计肾小球滤过率(eGFR)。在训练集中,该模型显示出中等程度的辨别能力,接收者操作特征曲线下面积为 0.863(95% 置信区间:0.831-0.894)。校准曲线显示,训练集中 LVH 的预测概率与实际概率之间具有良好的一致性。此外,验证集进一步证实了预测提名图的可靠性。总之,由七个常规临床变量组成的简化提名图在早期识别患有盐敏感性高血压并有 LVH 高风险的年轻人方面表现出了良好的性能和临床实用性。
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来源期刊
Journal of Clinical Hypertension
Journal of Clinical Hypertension PERIPHERAL VASCULAR DISEASE-
CiteScore
5.80
自引率
7.10%
发文量
191
审稿时长
4-8 weeks
期刊介绍: The Journal of Clinical Hypertension is a peer-reviewed, monthly publication that serves internists, cardiologists, nephrologists, endocrinologists, hypertension specialists, primary care practitioners, pharmacists and all professionals interested in hypertension by providing objective, up-to-date information and practical recommendations on the full range of clinical aspects of hypertension. Commentaries and columns by experts in the field provide further insights into our original research articles as well as on major articles published elsewhere. Major guidelines for the management of hypertension are also an important feature of the Journal. Through its partnership with the World Hypertension League, JCH will include a new focus on hypertension and public health, including major policy issues, that features research and reviews related to disease characteristics and management at the population level.
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