ArticleJournal of medical Internet research2024
Development and Validation of a Nomogram-Based Model to Predict Primary Hypertension Within the Next Year in Children and Adolescents: Retrospective Cohort Study.
Article in Journal of medical Internet research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Development and validation of a clinical prediction model for acupuncture response in community-dwelling patients with chronic low back pain: a retrospective cohort study.BMC health services research · 2026Article
- Stress hyperglycemia ratio and incident hypertension in chinese middle-aged and older adults: mediating roles of lipids in a prospective cohort.Lipids in health and disease · 2025Article
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13 authors.
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Abstract
backgroundPrimary hypertension (PH) poses significant risks to children and adolescents. Few prediction models for the risk of PH in children and adolescents currently exist, posing a challenge for doctors in making informed clinical decisions.
objectiveThis study aimed to investigate the incidence and risk factors of PH in Chinese children and adolescents. It also aimed to establish and validate a nomogram-based model for predicting the next year's PH risk.
methodsA training cohort (n=3938, between January 1, 2008, and December 31, 2020) and a validation cohort (n=1269, between January 1, 2021, and July 1, 2023) were established for model training and validation. An independent cohort of 576 individuals was established for external validation of the model. The result of the least absolute shrinkage and selection operator regression technique was used to select the optimal predictive features, and multivariate logistic regression to construct the nomogram. The performance of the nomogram underwent assessment and validation through the area under the receiver operating characteristic curve, concordance index, calibration curves, decision curve analysis, clinical impact curves, and sensitivity analysis.
resultsThe PH risk factors that we have ultimately identified include gender (odds ratio [OR] 3.34, 95% CI 2.88 to 3.86; P<.001), age (OR 1.11, 95% CI 1.08 to 1.14; P<.001), family history of hypertension (OR 42.74, 95% CI 23.07 to 79.19; P<.001), fasting blood glucose (OR 6.07, 95% CI 4.74 to 7.78; P<.001), low-density lipoprotein cholesterol (OR 2.03, 95% CI 1.60 to 2.57; P<.001), and uric acid (OR 1.01, 95% CI 1.01 to 1.01; P<.001), while factor breastfeeding (OR 0.04, 95% CI 0.03 to 0.05; P<.001) has been identified as a protective factor. Subsequently, a nomogram has been constructed incorporating these factors. Areas under the receiver operating characteristic curves of the nomogram were 0.892 in the training cohort, 0.808 in the validation cohort, and 0.790 in the external validation cohort. Concordance indexes of the nomogram were 0.892 in the training cohort, 0.808 in the validation cohort, and 0.790 in the external validation cohort. The nomogram has been proven to have good clinical benefits and stability in calibration curves, decision curve analysis, clinical impact curves, and sensitivity analysis. Finally, we observed noteworthy differences in uric acid levels and family history of hypertension among various subgroups, demonstrating a high correlation with PH. Moreover, the web-based calculator of the nomogram was built online.
conclusionsWe have developed and validated a stable and reliable nomogram that can accurately predict PH risk within the next year among children and adolescents in primary care and offer effective and cost-efficient support for clinical decisions for the risk prediction of PH.
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