Quantitative Assessment Of The Risk Factors For Hypertension Incidence In The Population With Prehypertension In Tianjin

Objective To analyze and make quantity evaluation of the risk factors for 2-year hypertension incidence in population with prehypertension in Tianjin, the effects of the risk factors will be ordered by their risk scores, and then to calculate the comprehensive risk scores and evaluate the depressed risk of hypertension incidence after changing the variable risk factors, and to lay the foundation for predicting the risk of hypertension incident for individuals.To establish quantitative evaluation model for assessing the risk of hypertension.Methods Our study is a population-based prospective cohort study,men and women aged 40-70 with non-hypertension(SBP<140mm Hg and DBP<90mm Hg) were recruited with natural sampling method across 6 districts of Tianjin for participation in July 2011 to December 2012. All participants were given written informed consents, and completed a health questionnaire, physical examination and biochemical tests. Survey content includes:(1) general situation: age, gender, nationality, culture degree, occupation, marriage, family, as the number of live together.(2) lifestyle and habits: eating, sleeping, smoking, drinking, exercise, etc.(3) social psychological factors: personality, emotion, if there is a large trauma in recent years, whether in depressed condition for a long time, etc.(4) family history : any family history of high blood pressure.(5) physical examination(6) biochemical detection: extraction of elbow venous blood 5 ml, detection of blood lipid levels, serum creatinine, high sensitivity C-reactive protein(hs- CRP) and serum uric acid(SUA), electrolyte.And detection of fasting plasma glucose(FPG),to simplify the oral 75 g anhydrous glucose tolerance test(OGTT) glucose determination. To conduct routine urine test and urine trace albumin/creatinine ratio(urinary albuminto-creatinine ratio, UACR). We analyzed 622 subjects(208 males and 414 females)aged 40-70 with prehypertension. After 2 years follow-up, participants were divided into hypertension group(case group) and non-hypertension group( control group). Based on multiple factors Logistic regression and risk score calculation formula,we get the risk scores of the different levels of exposure risk factors in Tianjin prehypertension crowd and get the major risk factors which effecting 2 years hypertension incidence. Tocalculate individuals' comprehesive risk scores of prehypertension group, analyzing the judgment effect of hypertension risk model using the ROC curve.Results Multivariate stepwise Logistic regression showed the main risk factors for hypertension incidence.For prehypertensive male population, risk factors which influence the pathogenesis of hypertension including family history of hypertension,over-intake of salt, excessive drinking,Type A personality, depression,sleep less than 5 hours or more than 7 andhours, less family size, elevated LDL-C, microalbuminuria and diabetes, the five leading risk factors were microalbuminuria, over-intake of salt, depression, sleep less than 5 hours and LDL-C>4.12mmol/L. Corresponding risk scores were 26.228, 25.094, 20.201, 16.845 and 16.447 respectively. For prehypertensive female population, 9 risk factors were included, which were family history of hypertension, over-intake of salt, smoking, excessive drinking, Type A personality, depression, elevated LDL-C, hyperuricemia and diabetes, the five leading risk factors were smoking, depression, excessive drinking, over-intake of salt, and hyperuricemia. Corresponding risk scores were10.929, 4.142, 3.697, 3.420 and 3.293 respectively.In the models, the area under the ROC curve and its 95% CI were 0.910(0.868,0.953) in men; the sensitivity and specificity were(0.908,0.759). The area under the ROC curve and its 95% CI were 0.834(0.786,0.881) in women; the sensitivity and specificity were(0.737,0.832).Conclusions 1 ? The 2-year hypertension incidence of Tianjin prehypertension population is 34.2%(male 37.6%, female 32.6%)2?For prehypertensive male population, the five leading risk factors which influence the pathogenesis of hypertension were microalbuminuria, over-intake of salt, depression, sleep less than 5 hours and LDLC>4.12mmol/L.3 ? For prehypertensive female population, the five leading risk factors which influence the pathogenesis of hypertension were smoking, depression, excessive drinking, over-intake of salt, and hyperuricemia.4?By quantitative model for risk factors of hypertension, we can use individual comprehensive risk score to predict the risk of hypertension incidence.