A Hypertension Risk Score for Middle-Aged and Older Adults

Authors

  • Abhijit V. Kshirsagar MD, MPH,

    1. From the Department of Medicine, UNC Kidney Center and Division of Nephrology and Hypertension, School of Medicine, Chapel Hill, NC ; 1the Department of Public Health, Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, New York, NY ; 2the Division of Nephrology, Columbia University School of Medicine, New York, NY ; 3the Department of Medicine, Division of Nephrology and Hypertension, Weill Medical College of Cornell University, New York, NY ; 4 and the Department of Family Medicine, UNC School of Medicine, Chapel Hill, NC5
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  • 1 Ya-lin Chiu MS,

    1. From the Department of Medicine, UNC Kidney Center and Division of Nephrology and Hypertension, School of Medicine, Chapel Hill, NC ; 1the Department of Public Health, Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, New York, NY ; 2the Division of Nephrology, Columbia University School of Medicine, New York, NY ; 3the Department of Medicine, Division of Nephrology and Hypertension, Weill Medical College of Cornell University, New York, NY ; 4 and the Department of Family Medicine, UNC School of Medicine, Chapel Hill, NC5
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  • 2 Andrew S. Bomback MD, MPH,

    1. From the Department of Medicine, UNC Kidney Center and Division of Nephrology and Hypertension, School of Medicine, Chapel Hill, NC ; 1the Department of Public Health, Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, New York, NY ; 2the Division of Nephrology, Columbia University School of Medicine, New York, NY ; 3the Department of Medicine, Division of Nephrology and Hypertension, Weill Medical College of Cornell University, New York, NY ; 4 and the Department of Family Medicine, UNC School of Medicine, Chapel Hill, NC5
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  • 3 Phyllis A. August MD,

    1. From the Department of Medicine, UNC Kidney Center and Division of Nephrology and Hypertension, School of Medicine, Chapel Hill, NC ; 1the Department of Public Health, Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, New York, NY ; 2the Division of Nephrology, Columbia University School of Medicine, New York, NY ; 3the Department of Medicine, Division of Nephrology and Hypertension, Weill Medical College of Cornell University, New York, NY ; 4 and the Department of Family Medicine, UNC School of Medicine, Chapel Hill, NC5
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  • 4 Anthony J. Viera MD, MPH,

    1. From the Department of Medicine, UNC Kidney Center and Division of Nephrology and Hypertension, School of Medicine, Chapel Hill, NC ; 1the Department of Public Health, Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, New York, NY ; 2the Division of Nephrology, Columbia University School of Medicine, New York, NY ; 3the Department of Medicine, Division of Nephrology and Hypertension, Weill Medical College of Cornell University, New York, NY ; 4 and the Department of Family Medicine, UNC School of Medicine, Chapel Hill, NC5
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  • 5 Romulo E. Colindres MD, MPSH,

    1. From the Department of Medicine, UNC Kidney Center and Division of Nephrology and Hypertension, School of Medicine, Chapel Hill, NC ; 1the Department of Public Health, Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, New York, NY ; 2the Division of Nephrology, Columbia University School of Medicine, New York, NY ; 3the Department of Medicine, Division of Nephrology and Hypertension, Weill Medical College of Cornell University, New York, NY ; 4 and the Department of Family Medicine, UNC School of Medicine, Chapel Hill, NC5
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  • and 1 Heejung Bang PhD 2

    1. From the Department of Medicine, UNC Kidney Center and Division of Nephrology and Hypertension, School of Medicine, Chapel Hill, NC ; 1the Department of Public Health, Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, New York, NY ; 2the Division of Nephrology, Columbia University School of Medicine, New York, NY ; 3the Department of Medicine, Division of Nephrology and Hypertension, Weill Medical College of Cornell University, New York, NY ; 4 and the Department of Family Medicine, UNC School of Medicine, Chapel Hill, NC5
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Abhijit V. Kshirsagar, MD, MPH, Department of Medicine, UNC Kidney Center and Division of Nephrology and Hypertension, School of Medicine, CB 7155 7017 Burnett-Womack Hall, Chapel Hill, NC 27599
E-mail: sagar@med.unc.edu

Abstract

J Clin Hypertens (Greenwich).

Determining which demographic and medical variables predict the development of hypertension could help clinicians stratify risk in both prehypertensive and nonhypertensive persons. Subject-level data from 2 community-based biracial cohorts were combined to ascertain the relationship between baseline characteristics and incident hypertension. Hypertension, defined as diastolic blood pressure ≥90 mm Hg, systolic blood pressure ≥140 mm Hg, or reported use of medication known to treat hypertension, was assessed prospectively at 3, 6, and 9 years. Internal validation was performed by the split-sample method with a 2:1 ratio for training and testing samples, respectively. A scoring algorithm was developed by converting the multivariable regression coefficients to integer values. Age, level of systolic or diastolic blood pressure, smoking, family history of hypertension, diabetes mellitus, high body mass index, female sex, and lack of exercise were associated with the development of hypertension in the training sample. Regression models showed moderate to high capabilities of discrimination between hypertension vs nonhypertension (area under the receiver operating characteristic curve 0.75–0.78) in the testing sample at 3, 6, and 9 years of follow-up. This risk calculator may aide health care providers in guiding discussions with patients about the risk for progression to hypertension. J Clin Hypertens (Greenwich). 2010;12:800-808. © 2010 WileyPeriodicals, Inc.

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