Developing the 10-year Persian Adult Hypertension Risk Score (PAHRS) Based on Yazd YHHC Healthy Heart Cohort (YHHC) Study: A Longitudinal Study on 20-74 Year-Old Population of Yazd

Abstract

Introduction Hypertension is major risk factor for cardiovascular and renal diseases and has become one of the major global challenges.To Development of a 10-year Persian Adult Hypertension Risk Score (PAHRS) based on Yazd healthy heart cohort study data. The present study is a longitudinal study as a sub study of Yazd Healthy Heart Cohort (YHHC). Method A total number of 1152 out of 2000 participants aged 20–74 years without hypertension at baseline were included in this study. The risk scoring system was used to predict the incidence of hypertension over a ten-year follow-up using logistic regression model. The performance of the predictive algorithm was evaluated using calibration and model discrimination. A web application was developed based on this study result and risk assessment system with link of https://survey.porsline.ir/s/2OGlwx6H. Result A total number of 324 patients (36.3%, mean age of 42.8 years) became hypertensive at the end of the 10-year follow up of the present study. In the multivariate logistic regression model, age, family history of hypertension, baseline systolic hypertension, history of diabetes, hyperglycemia, and obesity were identified as independent predictors of hypertension. Participants according to their ten-years hypertension risk by the point score system classified into three groups: low-risk, with a risk of < 10% in 135 participant (11.7%) and intermediate-risk,with a mean risk of 10% -20% in 319 participant (27.7%) and high-risk with a risk of > 20% in 698 participant(60.6% ). The value of C statistic for the point score system was calculated to be 0.72 and the Hosmer-Lemeshow test for the calibration was acceptable (χ² = 3.26, P = 0.917) for ten years of incidence of hypertension in the YHHC study. Conclusion The Persian Adult Hypertension Risk Score (PAHRS), which was developed for the first time using Yazd native residents' data, is a simple and useful tool in hypertension risk assessment and consider prevention program based on high risk population approach.. The almost two third of the our study population was estimated to be at high risk for hypertension during ten years so using our risk scoring system can be used for health policy in primary prevention of hypertension in communities.