Construction And Verification Of Individualized Nomogram Model For Risk Of Essential Hypertension Complicated With Coronary Heart Disease

ObjectiveTo explore the risk factors of EH patients complicated with CHD,and to construct an individualized nomogram model for predicting the risk of EH patients complicated with CHD based on independent risk factors.To evaluate the probability of CHD risk in patients with early EH,and to provide a reference scale for early intervention.Methods1.The general information and medical records of hospitalized patients in Huaihe Hospital of Henan University from January 2018 to December 2021 were retrospectively collected.According to the inclusion and exclusion criteria,150 patients with complete data and in accordance with EH complicated with CHD(EH complicated with CHD group)were included in the study.The general information and medical records of 150 simple EH patients without CHD(simple EH group)during the same period were randomly selected,and a total of 300 medical records were collected.2.The clinical data of the two groups were analyzed by univariate analysis,and the variables with P<0.05 were included in the multivariate Logistic analysis.The variables with P<0.05 in the multivariate analysis were included in the final risk prediction model.3.The nomogram was drawn according to the results of multivariate Logistic regression analysis,and the discrimination,calibration and clinical applicability of the nomogram model were verified by ROC curve,calibration curve and decision analysis curve(DCA curve).Results1.The variables with statistical differences(P<0.05)by single factor analysis: age,BMI,history of diabetes,smoking history,LPa,AIP,homocysteine,cystatin C,and high-sensitivity C-reactive protein may be risk factors for CHD in patients with EH.2.Multivariate logistic regression analysis showed that age,BMI,history of diabetes,AIP,homocysteine,cystatin C,and high-sensitivity C-reactive protein were the main risk factors for CHD in EH patients(P<0.05),and an individualized nomogram model was drawn based on these factors.3.The AUC of the nomogram in the ROC curve was 0.791,indicating that the nomogram model had good discrimination.The calibration chart and Bootstrap method showed that the predicted value was highly consistent with the actual value,and the curve fitting degree was good,indicating that the prediction accuracy of the model was good.From the perspective of efficiency,the benefit of DCA curve is significantly higher than that of the extreme curve,indicating that the model has good clinical applicability.ConclusionsMultivariate logistic regression analysis showed that age,BMI,history of diabetes,AIP,homocysteine,cystatin C,and high-sensitivity C-reactive protein were independent risk factors for CHD in EH patients(P<0.05),and based on the results,an individualized nomogram model was drawn to predict the risk of CHD in EH patients.The individualized nomogram model is simple and clear,which can help clinicians to carry out early intervention and treatment for hypertensive patients with high risk of coronary heart disease,and improve the prognosis.It has high practicability in clinical practice.