Barriers to Access to Treatment for Hypertensive Patients in Primary Health Care of Less Developed Northwest China: A Predictive Nomogram
Background. This study aims to evaluate the risk factors associated with untreated hypertension and develop and internally validate untreated risk nomograms in patients with hypertension among primary health care of less developed Northwest China. Methods. A total of 895 eligible patients with hyper...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | International Journal of Hypertension |
| Online Access: | http://dx.doi.org/10.1155/2021/6613231 |
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| author | Lin Wang Mulalibieke Heizhati Xintian Cai Mei Li Zhikang Yang Zhongrong Wang Reyila Abudereyimu Nanfang Li |
| author_facet | Lin Wang Mulalibieke Heizhati Xintian Cai Mei Li Zhikang Yang Zhongrong Wang Reyila Abudereyimu Nanfang Li |
| author_sort | Lin Wang |
| collection | DOAJ |
| description | Background. This study aims to evaluate the risk factors associated with untreated hypertension and develop and internally validate untreated risk nomograms in patients with hypertension among primary health care of less developed Northwest China. Methods. A total of 895 eligible patients with hypertension in primary health care of less developed Northwest China were divided into a training set (n = 626) and a validation set (n = 269). Untreated hypertension was defined as not taking antihypertensive medication during the past two weeks. Using least absolute shrinkage and selection operator (LASSO) regression model, we identified the optimized risk factors of nontreatment, followed by establishment of a prediction nomogram. The discriminative ability, calibration, and clinical usefulness were determined using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision analysis. The results were assessed by internal validation in the validation set. Results. Five independent risk factors were derived from LASSO regression model and entered into the nomogram: age, herdsman, family income per member, altitude of habitation, and comorbidity. The nomogram displayed a robust discrimination with an AUC of 0.859 (95% confidence interval: 0.812–0.906) and good calibration. The nomogram was clinically useful when the intervention was decided at the untreated possibility threshold of 7% to 91% in the decision curve analysis. Results were confirmed by internal validation. Conclusions. Our nomogram showed favorable predictive accuracy for untreated hypertension in primary health care of less developed Northwest China and might help primary health care assess the risk of nontreatment in patients with hypertension. |
| format | Article |
| id | doaj-art-e0b293fe868d4affac260ca2d5ccc5a2 |
| institution | OA Journals |
| issn | 2090-0384 2090-0392 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Hypertension |
| spelling | doaj-art-e0b293fe868d4affac260ca2d5ccc5a22025-08-20T02:21:30ZengWileyInternational Journal of Hypertension2090-03842090-03922021-01-01202110.1155/2021/66132316613231Barriers to Access to Treatment for Hypertensive Patients in Primary Health Care of Less Developed Northwest China: A Predictive NomogramLin Wang0Mulalibieke Heizhati1Xintian Cai2Mei Li3Zhikang Yang4Zhongrong Wang5Reyila Abudereyimu6Nanfang Li7Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, ChinaHypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, ChinaHypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, ChinaHypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, ChinaHypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, ChinaHypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, ChinaHypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, ChinaHypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, ChinaBackground. This study aims to evaluate the risk factors associated with untreated hypertension and develop and internally validate untreated risk nomograms in patients with hypertension among primary health care of less developed Northwest China. Methods. A total of 895 eligible patients with hypertension in primary health care of less developed Northwest China were divided into a training set (n = 626) and a validation set (n = 269). Untreated hypertension was defined as not taking antihypertensive medication during the past two weeks. Using least absolute shrinkage and selection operator (LASSO) regression model, we identified the optimized risk factors of nontreatment, followed by establishment of a prediction nomogram. The discriminative ability, calibration, and clinical usefulness were determined using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision analysis. The results were assessed by internal validation in the validation set. Results. Five independent risk factors were derived from LASSO regression model and entered into the nomogram: age, herdsman, family income per member, altitude of habitation, and comorbidity. The nomogram displayed a robust discrimination with an AUC of 0.859 (95% confidence interval: 0.812–0.906) and good calibration. The nomogram was clinically useful when the intervention was decided at the untreated possibility threshold of 7% to 91% in the decision curve analysis. Results were confirmed by internal validation. Conclusions. Our nomogram showed favorable predictive accuracy for untreated hypertension in primary health care of less developed Northwest China and might help primary health care assess the risk of nontreatment in patients with hypertension.http://dx.doi.org/10.1155/2021/6613231 |
| spellingShingle | Lin Wang Mulalibieke Heizhati Xintian Cai Mei Li Zhikang Yang Zhongrong Wang Reyila Abudereyimu Nanfang Li Barriers to Access to Treatment for Hypertensive Patients in Primary Health Care of Less Developed Northwest China: A Predictive Nomogram International Journal of Hypertension |
| title | Barriers to Access to Treatment for Hypertensive Patients in Primary Health Care of Less Developed Northwest China: A Predictive Nomogram |
| title_full | Barriers to Access to Treatment for Hypertensive Patients in Primary Health Care of Less Developed Northwest China: A Predictive Nomogram |
| title_fullStr | Barriers to Access to Treatment for Hypertensive Patients in Primary Health Care of Less Developed Northwest China: A Predictive Nomogram |
| title_full_unstemmed | Barriers to Access to Treatment for Hypertensive Patients in Primary Health Care of Less Developed Northwest China: A Predictive Nomogram |
| title_short | Barriers to Access to Treatment for Hypertensive Patients in Primary Health Care of Less Developed Northwest China: A Predictive Nomogram |
| title_sort | barriers to access to treatment for hypertensive patients in primary health care of less developed northwest china a predictive nomogram |
| url | http://dx.doi.org/10.1155/2021/6613231 |
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