Development and Validation of an Incident Hypertension Risk Prediction Model for Young Adults
Background Identifying young adults at high risk of hypertension can improve blood pressure screening recommendations. Methods We developed models to predict incident hypertension using diverse contemporary cohorts of young adults aged 18 to 39 years from Kaiser Permanente Southern California (deriv...
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2025-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.040769 |
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| author | Jaejin An Heidi Fischer Liang Ni Mengying Xia Soon Kyu Choi Kerresa L. Morrissette Rong Wei Kristi Reynolds Paul Muntner Lisandro D. Colantonio Andrew E. Moran Brandon K. Bellows Monika M. Safford Norrina B. Allen Vanessa Xanthakis Carmen R. Isasi Linda C. Gallo Krista M. Perreira Yiyi Zhang |
| author_facet | Jaejin An Heidi Fischer Liang Ni Mengying Xia Soon Kyu Choi Kerresa L. Morrissette Rong Wei Kristi Reynolds Paul Muntner Lisandro D. Colantonio Andrew E. Moran Brandon K. Bellows Monika M. Safford Norrina B. Allen Vanessa Xanthakis Carmen R. Isasi Linda C. Gallo Krista M. Perreira Yiyi Zhang |
| author_sort | Jaejin An |
| collection | DOAJ |
| description | Background Identifying young adults at high risk of hypertension can improve blood pressure screening recommendations. Methods We developed models to predict incident hypertension using diverse contemporary cohorts of young adults aged 18 to 39 years from Kaiser Permanente Southern California (derivation and internal validation) and 3 cohort studies (CARDIA [Coronary Artery Risk Development in Young Adults], FHS [Framingham Heart Study], HCHS/SOL [Hispanic Community Health Study/Study of Latinos]; external validation). Predictors included age, systolic and diastolic blood pressure, body mass index, smoking, social determinants of health, comorbidities, high‐ and low‐density lipoprotein cholesterol, and pregnancy‐related hypertensive disorders. We used Cox elastic net and random survival forests to develop sex‐specific models and compared their performance to 2021 US Preventive Services Task Force blood pressure screening recommendations. Results Among 355 524 adults from Kaiser Permanente Southern California (mean age, 29 years; mean systolic/diastolic blood pressure, 115/70 mm Hg), 11.7% developed hypertension in a median of 5.4 years. External validation showed good discrimination and calibration (Harrell's C‐statistic, 0.76 and 0.82; Integrated Brier Score, 0.04 and 0.02 for men and women, respectively). Compared with US Preventive Services Task Force, a 10‐year risk for hypertension of ≥15% in the external cohort using the new model showed similar sensitivity (men, 0.90 versus 0.89; women, 0.81 versus 0.81) and moderate improvement in specificity (men, 0.35 versus 0.25; women, 0.66 versus 0.44). Using the National Health and Nutrition Examination Survey, the prediction model estimated 28.5 million US young adults being at high risk of hypertension compared with 45.3 million by the US Preventive Services Task Force. Conclusions Compared with the US Preventive Services Task Force, the hypertension risk prediction model may be a more efficient tool to identify high‐risk young adults for early intervention. |
| format | Article |
| id | doaj-art-eaad9bb6f5a64488b25e19acbbb485f8 |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-eaad9bb6f5a64488b25e19acbbb485f82025-08-20T03:13:00ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-07-01141410.1161/JAHA.124.040769Development and Validation of an Incident Hypertension Risk Prediction Model for Young AdultsJaejin An0Heidi Fischer1Liang Ni2Mengying Xia3Soon Kyu Choi4Kerresa L. Morrissette5Rong Wei6Kristi Reynolds7Paul Muntner8Lisandro D. Colantonio9Andrew E. Moran10Brandon K. Bellows11Monika M. Safford12Norrina B. Allen13Vanessa Xanthakis14Carmen R. Isasi15Linda C. Gallo16Krista M. Perreira17Yiyi Zhang18Department of Research & Evaluation Kaiser Permanente Southern California Pasadena CA USADepartment of Research & Evaluation Kaiser Permanente Southern California Pasadena CA USADepartment of Research & Evaluation Kaiser Permanente Southern California Pasadena CA USADivision of General Medicine Columbia University Irving Medical Center New York NY USADepartment of Research & Evaluation Kaiser Permanente Southern California Pasadena CA USADepartment of Research & Evaluation Kaiser Permanente Southern California Pasadena CA USADepartment of Research & Evaluation Kaiser Permanente Southern California Pasadena CA USADepartment of Research & Evaluation Kaiser Permanente Southern California Pasadena CA USADepartment of Epidemiology University of Alabama at Birmingham Birmingham AL USADepartment of Epidemiology University of Alabama at Birmingham Birmingham AL USADivision of General Medicine Columbia University Irving Medical Center New York NY USADivision of General Medicine Columbia University Irving Medical Center New York NY USADivision of General Internal Medicine Weill Cornell Medicine New York NY USADivision of Epidemiology Northwestern University Chicago IL USADepartment of Medicine Boston University Chobanian and Avedisian School of Medicine Boston MA USADepartment of Epidemiology and Population Health Albert Einstein College of Medicine Bronx NY USADepartment of Psychology San Diego State University San Diego CA USADepartment of Social Medicine University of North Carolina School of Medicine Chapel Hill NC USADivision of General Medicine Columbia University Irving Medical Center New York NY USABackground Identifying young adults at high risk of hypertension can improve blood pressure screening recommendations. Methods We developed models to predict incident hypertension using diverse contemporary cohorts of young adults aged 18 to 39 years from Kaiser Permanente Southern California (derivation and internal validation) and 3 cohort studies (CARDIA [Coronary Artery Risk Development in Young Adults], FHS [Framingham Heart Study], HCHS/SOL [Hispanic Community Health Study/Study of Latinos]; external validation). Predictors included age, systolic and diastolic blood pressure, body mass index, smoking, social determinants of health, comorbidities, high‐ and low‐density lipoprotein cholesterol, and pregnancy‐related hypertensive disorders. We used Cox elastic net and random survival forests to develop sex‐specific models and compared their performance to 2021 US Preventive Services Task Force blood pressure screening recommendations. Results Among 355 524 adults from Kaiser Permanente Southern California (mean age, 29 years; mean systolic/diastolic blood pressure, 115/70 mm Hg), 11.7% developed hypertension in a median of 5.4 years. External validation showed good discrimination and calibration (Harrell's C‐statistic, 0.76 and 0.82; Integrated Brier Score, 0.04 and 0.02 for men and women, respectively). Compared with US Preventive Services Task Force, a 10‐year risk for hypertension of ≥15% in the external cohort using the new model showed similar sensitivity (men, 0.90 versus 0.89; women, 0.81 versus 0.81) and moderate improvement in specificity (men, 0.35 versus 0.25; women, 0.66 versus 0.44). Using the National Health and Nutrition Examination Survey, the prediction model estimated 28.5 million US young adults being at high risk of hypertension compared with 45.3 million by the US Preventive Services Task Force. Conclusions Compared with the US Preventive Services Task Force, the hypertension risk prediction model may be a more efficient tool to identify high‐risk young adults for early intervention.https://www.ahajournals.org/doi/10.1161/JAHA.124.040769hypertensionprediction modelyoung adults |
| spellingShingle | Jaejin An Heidi Fischer Liang Ni Mengying Xia Soon Kyu Choi Kerresa L. Morrissette Rong Wei Kristi Reynolds Paul Muntner Lisandro D. Colantonio Andrew E. Moran Brandon K. Bellows Monika M. Safford Norrina B. Allen Vanessa Xanthakis Carmen R. Isasi Linda C. Gallo Krista M. Perreira Yiyi Zhang Development and Validation of an Incident Hypertension Risk Prediction Model for Young Adults Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease hypertension prediction model young adults |
| title | Development and Validation of an Incident Hypertension Risk Prediction Model for Young Adults |
| title_full | Development and Validation of an Incident Hypertension Risk Prediction Model for Young Adults |
| title_fullStr | Development and Validation of an Incident Hypertension Risk Prediction Model for Young Adults |
| title_full_unstemmed | Development and Validation of an Incident Hypertension Risk Prediction Model for Young Adults |
| title_short | Development and Validation of an Incident Hypertension Risk Prediction Model for Young Adults |
| title_sort | development and validation of an incident hypertension risk prediction model for young adults |
| topic | hypertension prediction model young adults |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.040769 |
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