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Satoh M, Metoki H, Asayama K, Kikuya M, Murakami T, Tatsumi Y, Hara A, Tsubota-Utsugi M, Hirose T, Inoue R, Nomura K, Hozawa A, Imai Y, Ohkubo T. Prediction Models for the 5- and 10-Year Incidence of Home Morning Hypertension: The Ohasama Study. Am J Hypertens 2022; 35:328-336. [PMID: 34791013 DOI: 10.1093/ajh/hpab177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/23/2021] [Accepted: 11/12/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We aimed to develop risk prediction models for new-onset home morning hypertension. METHODS We followed up 978 participants without home hypertension in the general population of Ohasama, Japan (men: 30.1%, age: 53.3 years). The participants were divided into derivation (n = 489) and validation (n = 489) cohorts by their residential area. The C-statistics and calibration plots were assessed after the 5- or 10-year follow-up. RESULTS In the derivation cohort, sex, age, body mass index, smoking, office systolic blood pressure (SBP), and home SBP at baseline were selected as significant risk factors for new-onset home hypertension (≥135/85 mm Hg or the initiation of antihypertensive treatment) using the Cox model. In the validation cohort, Harrell's C-statistic for the 5-/10-year home hypertension was 0.7637 (0.7195-0.8100)/0.7308 (0.6932-0.7677), when we used the full model, which included the significant risk factors in the derivation cohort. The calibration test revealed good concordance between the observed and predicted 5-/10-year home hypertension probabilities (P ≥ 0.19); the regression slope of the observed probability on the predicted probability was 1.10/1.02, and the intercept was -0.04/0.06, respectively. A model without home SBP was also developed; for the 10-year home hypertension risk, the calibration test revealed a good concordance (P = 0.19) but Harrell's C-statistic was 0.6689 (0.6266-0.7067). CONCLUSIONS The full model revealed good ability to predict the 5- and 10-year home morning hypertension risk. Although the model without home SBP is acceptable, the low C-statistic implies that home BP should be measured to predict home morning hypertension precisely.
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Affiliation(s)
- Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Kei Asayama
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Masahiro Kikuya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Takahisa Murakami
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yukako Tatsumi
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Azusa Hara
- Division of Drug Development and Regulatory Science, Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
| | - Megumi Tsubota-Utsugi
- Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine, Iwate, Japan
| | - Takuo Hirose
- Department of Endocrinology and Applied Medical Science, Tohoku University Graduate School of Medicine, Sendai, Japan
- Division of Integrative Renal Replacement Therapy, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Ryusuke Inoue
- Department of Medical Information Technology Center, Tohoku University Hospital, Sendai, Japan
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Yutaka Imai
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Takayoshi Ohkubo
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
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Schiffrin EL. From the Editor-in-Chief: Issue at a Glance. Am J Hypertens 2021; 34:229-230. [PMID: 33821944 DOI: 10.1093/ajh/hpab033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ernesto L Schiffrin
- The American Journal of Hypertension, Lady Davis Institute for Medical Research, and Department of Medicine, Sir Mortimer B. Davis, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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