A deep learning digital biomarker to detect hypertension and stratify cardiovascular risk from the electrocardiogram
Abstract Hypertension is a major risk factor for cardiovascular disease (CVD), yet blood pressure is measured intermittently and under suboptimal conditions. We developed a deep learning model to identify hypertension and stratify risk of CVD using 12-lead electrocardiogram waveforms. HTN-AI was tra...
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| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-02-01
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| Series: | npj Digital Medicine |
| Online Access: | https://doi.org/10.1038/s41746-025-01491-8 |
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| Summary: | Abstract Hypertension is a major risk factor for cardiovascular disease (CVD), yet blood pressure is measured intermittently and under suboptimal conditions. We developed a deep learning model to identify hypertension and stratify risk of CVD using 12-lead electrocardiogram waveforms. HTN-AI was trained to detect hypertension using 752,415 electrocardiograms from 103,405 adults at Massachusetts General Hospital. We externally validated HTN-AI and demonstrated associations between HTN-AI risk and incident CVD in 56,760 adults at Brigham and Women’s Hospital. HTN-AI accurately discriminated hypertension (internal and external validation AUROC 0.803 and 0.771, respectively). In Fine-Gray regression analyses model-predicted probability of hypertension was associated with mortality (hazard ratio per standard deviation: 1.47 [1.36-1.60], p < 0.001), HF (2.26 [1.90-2.69], p < 0.001), MI (1.87 [1.69-2.07], p < 0.001), stroke (1.30 [1.18-1.44], p < 0.001), and aortic dissection or rupture (1.69 [1.22-2.35], p < 0.001) after adjustment for demographics and risk factors. HTN-AI may facilitate diagnosis of hypertension and serve as a digital biomarker of hypertension-associated CVD. |
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| ISSN: | 2398-6352 |