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Comparison of the Framingham Heart Study Hypertension Model With Blood Pressure Alone in the Prediction of Risk of Hypertension: The Multi-Ethnic Study of Atherosclerosis

A prediction model, developed in the Framingham Heart Study (FHS), has been proposed for use in estimating a given individualʼs risk of hypertension. We compared this model with systolic blood pressure (SBP) alone and age-specific diastolic blood pressure categories for the prediction of hypertensio... Full description

Journal Title: Hypertension (Dallas Tex. 1979), 2010-06, Vol.55 (6), p.1339-1345
Main Author: Muntner, Paul
Other Authors: Woodward, Mark , Mann, Devin M , Shimbo, Daichi , Michos, Erin D , Blumenthal, Roger S , Carson, April P , Chen, Haiying , Arnett, Donna K
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age Distribution
Aged
Aged, 80 and over
Antihypertensive Agents - therapeutic use
Arterial hypertension. Arterial hypotension
Article
Biological and medical sciences
Blood and lymphatic vessels
Blood Pressure Determination
Cardiology. Vascular system
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Cohort Studies
Confidence Intervals
Coronary Artery Disease - diagnosis
Coronary Artery Disease - drug therapy
Coronary Artery Disease - ethnology
Diastole - physiology
diastolic blood pressure
epidemiology
Ethnic Groups - statistics & numerical data
Female
Follow-Up Studies
Humans
hypertension
Hypertension - diagnosis
Hypertension - drug therapy
Hypertension - ethnology
Incidence
Linear Models
Male
Medical sciences
Middle Aged
Models, Cardiovascular
Predictive Value of Tests
Probability
Risk Assessment
risk prediction
Severity of Illness Index
Sex Distribution
Systole - physiology
systolic blood pressure
Publisher: Hagerstown, MD: American Heart Association, Inc
ID: ISSN: 0194-911X
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3023992
title: Comparison of the Framingham Heart Study Hypertension Model With Blood Pressure Alone in the Prediction of Risk of Hypertension: The Multi-Ethnic Study of Atherosclerosis
format: Article
creator:
  • Muntner, Paul
  • Woodward, Mark
  • Mann, Devin M
  • Shimbo, Daichi
  • Michos, Erin D
  • Blumenthal, Roger S
  • Carson, April P
  • Chen, Haiying
  • Arnett, Donna K
subjects:
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents - therapeutic use
  • Arterial hypertension. Arterial hypotension
  • Article
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • Blood Pressure Determination
  • Cardiology. Vascular system
  • Clinical manifestations. Epidemiology. Investigative techniques. Etiology
  • Cohort Studies
  • Confidence Intervals
  • Coronary Artery Disease - diagnosis
  • Coronary Artery Disease - drug therapy
  • Coronary Artery Disease - ethnology
  • Diastole - physiology
  • diastolic blood pressure
  • epidemiology
  • Ethnic Groups - statistics & numerical data
  • Female
  • Follow-Up Studies
  • Humans
  • hypertension
  • Hypertension - diagnosis
  • Hypertension - drug therapy
  • Hypertension - ethnology
  • Incidence
  • Linear Models
  • Male
  • Medical sciences
  • Middle Aged
  • Models, Cardiovascular
  • Predictive Value of Tests
  • Probability
  • Risk Assessment
  • risk prediction
  • Severity of Illness Index
  • Sex Distribution
  • Systole - physiology
  • systolic blood pressure
ispartof: Hypertension (Dallas, Tex. 1979), 2010-06, Vol.55 (6), p.1339-1345
description: A prediction model, developed in the Framingham Heart Study (FHS), has been proposed for use in estimating a given individualʼs risk of hypertension. We compared this model with systolic blood pressure (SBP) alone and age-specific diastolic blood pressure categories for the prediction of hypertension. Participants in the Multi-Ethnic Study of Atherosclerosis, without hypertension or diabetes mellitus (n=3013), were followed for the incidence of hypertension (SBP ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg and/or the initiation of antihypertensive medication). The predicted probability of developing hypertension among 4 adjacent study examinations, with a median of 1.6 years between examinations, was determined. The mean (SD) age of participants was 58.5 (9.7) years, and 53% were women. During follow-up, 849 incident cases of hypertension occurred. The c statistic for the FHS model was 0.788 (95% CI0.773 to 0.804) compared with 0.768 (95% CI0.751 to 0.785; P=0.096 compared with the FHS model) for SBP alone and 0.699 (95% CI0.681 to 0.717; P
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
url: Link


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titleComparison of the Framingham Heart Study Hypertension Model With Blood Pressure Alone in the Prediction of Risk of Hypertension: The Multi-Ethnic Study of Atherosclerosis
creatorMuntner, Paul ; Woodward, Mark ; Mann, Devin M ; Shimbo, Daichi ; Michos, Erin D ; Blumenthal, Roger S ; Carson, April P ; Chen, Haiying ; Arnett, Donna K
creatorcontribMuntner, Paul ; Woodward, Mark ; Mann, Devin M ; Shimbo, Daichi ; Michos, Erin D ; Blumenthal, Roger S ; Carson, April P ; Chen, Haiying ; Arnett, Donna K
descriptionA prediction model, developed in the Framingham Heart Study (FHS), has been proposed for use in estimating a given individualʼs risk of hypertension. We compared this model with systolic blood pressure (SBP) alone and age-specific diastolic blood pressure categories for the prediction of hypertension. Participants in the Multi-Ethnic Study of Atherosclerosis, without hypertension or diabetes mellitus (n=3013), were followed for the incidence of hypertension (SBP ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg and/or the initiation of antihypertensive medication). The predicted probability of developing hypertension among 4 adjacent study examinations, with a median of 1.6 years between examinations, was determined. The mean (SD) age of participants was 58.5 (9.7) years, and 53% were women. During follow-up, 849 incident cases of hypertension occurred. The c statistic for the FHS model was 0.788 (95% CI0.773 to 0.804) compared with 0.768 (95% CI0.751 to 0.785; P=0.096 compared with the FHS model) for SBP alone and 0.699 (95% CI0.681 to 0.717; P<0.001 compared with the FHS model) for age-specific diastolic blood pressure categories. The relative integrated discrimination improvement index for the FHS model versus SBP alone was 10.0% (95% CI−1.7% to 22.7%) and versus age-specific diastolic blood pressure categories was 146.0% (95% CI116.0% to 181.0%). Using the FHS model, there were significant differences between observed and predicted hypertension risks (Hosmer-Lemeshow goodness of fitP<0.001); recalibrated and best-fit models produced a better model fit (P=0.064 and 0.245, respectively). In this multiethnic cohort of US adults, the FHS model was not substantially better than SBP alone for predicting hypertension.
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subjectAge Distribution ; Aged ; Aged, 80 and over ; Antihypertensive Agents - therapeutic use ; Arterial hypertension. Arterial hypotension ; Article ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Pressure Determination ; Cardiology. Vascular system ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; Cohort Studies ; Confidence Intervals ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - drug therapy ; Coronary Artery Disease - ethnology ; Diastole - physiology ; diastolic blood pressure ; epidemiology ; Ethnic Groups - statistics & numerical data ; Female ; Follow-Up Studies ; Humans ; hypertension ; Hypertension - diagnosis ; Hypertension - drug therapy ; Hypertension - ethnology ; Incidence ; Linear Models ; Male ; Medical sciences ; Middle Aged ; Models, Cardiovascular ; Predictive Value of Tests ; Probability ; Risk Assessment ; risk prediction ; Severity of Illness Index ; Sex Distribution ; Systole - physiology ; systolic blood pressure
ispartofHypertension (Dallas, Tex. 1979), 2010-06, Vol.55 (6), p.1339-1345
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0Muntner, Paul
1Woodward, Mark
2Mann, Devin M
3Shimbo, Daichi
4Michos, Erin D
5Blumenthal, Roger S
6Carson, April P
7Chen, Haiying
8Arnett, Donna K
title
0Comparison of the Framingham Heart Study Hypertension Model With Blood Pressure Alone in the Prediction of Risk of Hypertension: The Multi-Ethnic Study of Atherosclerosis
1Hypertension (Dallas, Tex. 1979)
addtitleHypertension
descriptionA prediction model, developed in the Framingham Heart Study (FHS), has been proposed for use in estimating a given individualʼs risk of hypertension. We compared this model with systolic blood pressure (SBP) alone and age-specific diastolic blood pressure categories for the prediction of hypertension. Participants in the Multi-Ethnic Study of Atherosclerosis, without hypertension or diabetes mellitus (n=3013), were followed for the incidence of hypertension (SBP ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg and/or the initiation of antihypertensive medication). The predicted probability of developing hypertension among 4 adjacent study examinations, with a median of 1.6 years between examinations, was determined. The mean (SD) age of participants was 58.5 (9.7) years, and 53% were women. During follow-up, 849 incident cases of hypertension occurred. The c statistic for the FHS model was 0.788 (95% CI0.773 to 0.804) compared with 0.768 (95% CI0.751 to 0.785; P=0.096 compared with the FHS model) for SBP alone and 0.699 (95% CI0.681 to 0.717; P<0.001 compared with the FHS model) for age-specific diastolic blood pressure categories. The relative integrated discrimination improvement index for the FHS model versus SBP alone was 10.0% (95% CI−1.7% to 22.7%) and versus age-specific diastolic blood pressure categories was 146.0% (95% CI116.0% to 181.0%). Using the FHS model, there were significant differences between observed and predicted hypertension risks (Hosmer-Lemeshow goodness of fitP<0.001); recalibrated and best-fit models produced a better model fit (P=0.064 and 0.245, respectively). In this multiethnic cohort of US adults, the FHS model was not substantially better than SBP alone for predicting hypertension.
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0Age Distribution
1Aged
2Aged, 80 and over
3Antihypertensive Agents - therapeutic use
4Arterial hypertension. Arterial hypotension
5Article
6Biological and medical sciences
7Blood and lymphatic vessels
8Blood Pressure Determination
9Cardiology. Vascular system
10Clinical manifestations. Epidemiology. Investigative techniques. Etiology
11Cohort Studies
12Confidence Intervals
13Coronary Artery Disease - diagnosis
14Coronary Artery Disease - drug therapy
15Coronary Artery Disease - ethnology
16Diastole - physiology
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18epidemiology
19Ethnic Groups - statistics & numerical data
20Female
21Follow-Up Studies
22Humans
23hypertension
24Hypertension - diagnosis
25Hypertension - drug therapy
26Hypertension - ethnology
27Incidence
28Linear Models
29Male
30Medical sciences
31Middle Aged
32Models, Cardiovascular
33Predictive Value of Tests
34Probability
35Risk Assessment
36risk prediction
37Severity of Illness Index
38Sex Distribution
39Systole - physiology
40systolic blood pressure
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1Woodward, Mark
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3Shimbo, Daichi
4Michos, Erin D
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6Carson, April P
7Chen, Haiying
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titleComparison of the Framingham Heart Study Hypertension Model With Blood Pressure Alone in the Prediction of Risk of Hypertension: The Multi-Ethnic Study of Atherosclerosis
authorMuntner, Paul ; Woodward, Mark ; Mann, Devin M ; Shimbo, Daichi ; Michos, Erin D ; Blumenthal, Roger S ; Carson, April P ; Chen, Haiying ; Arnett, Donna K
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1Aged
2Aged, 80 and over
3Antihypertensive Agents - therapeutic use
4Arterial hypertension. Arterial hypotension
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6Biological and medical sciences
7Blood and lymphatic vessels
8Blood Pressure Determination
9Cardiology. Vascular system
10Clinical manifestations. Epidemiology. Investigative techniques. Etiology
11Cohort Studies
12Confidence Intervals
13Coronary Artery Disease - diagnosis
14Coronary Artery Disease - drug therapy
15Coronary Artery Disease - ethnology
16Diastole - physiology
17diastolic blood pressure
18epidemiology
19Ethnic Groups - statistics & numerical data
20Female
21Follow-Up Studies
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24Hypertension - diagnosis
25Hypertension - drug therapy
26Hypertension - ethnology
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28Linear Models
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30Medical sciences
31Middle Aged
32Models, Cardiovascular
33Predictive Value of Tests
34Probability
35Risk Assessment
36risk prediction
37Severity of Illness Index
38Sex Distribution
39Systole - physiology
40systolic blood pressure
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1Woodward, Mark
2Mann, Devin M
3Shimbo, Daichi
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7Chen, Haiying
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abstractA prediction model, developed in the Framingham Heart Study (FHS), has been proposed for use in estimating a given individualʼs risk of hypertension. We compared this model with systolic blood pressure (SBP) alone and age-specific diastolic blood pressure categories for the prediction of hypertension. Participants in the Multi-Ethnic Study of Atherosclerosis, without hypertension or diabetes mellitus (n=3013), were followed for the incidence of hypertension (SBP ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg and/or the initiation of antihypertensive medication). The predicted probability of developing hypertension among 4 adjacent study examinations, with a median of 1.6 years between examinations, was determined. The mean (SD) age of participants was 58.5 (9.7) years, and 53% were women. During follow-up, 849 incident cases of hypertension occurred. The c statistic for the FHS model was 0.788 (95% CI0.773 to 0.804) compared with 0.768 (95% CI0.751 to 0.785; P=0.096 compared with the FHS model) for SBP alone and 0.699 (95% CI0.681 to 0.717; P<0.001 compared with the FHS model) for age-specific diastolic blood pressure categories. The relative integrated discrimination improvement index for the FHS model versus SBP alone was 10.0% (95% CI−1.7% to 22.7%) and versus age-specific diastolic blood pressure categories was 146.0% (95% CI116.0% to 181.0%). Using the FHS model, there were significant differences between observed and predicted hypertension risks (Hosmer-Lemeshow goodness of fitP<0.001); recalibrated and best-fit models produced a better model fit (P=0.064 and 0.245, respectively). In this multiethnic cohort of US adults, the FHS model was not substantially better than SBP alone for predicting hypertension.
copHagerstown, MD
pubAmerican Heart Association, Inc
pmid20439822
doi10.1161/HYPERTENSIONAHA.109.149609
oafree_for_read