Risk Prediction Model for Uncontrolled Hypertension in Chinese Community

Background: Uncontrolled hypertension rate was still high across China. This study develops and validates an index to help quantify the combination of socio-behavioral aspects to screen high-risk patients in uncontrolled hypertension in Chinese primary care.

Methods: A cross-sectional study included 1,039 of patients with hypertension in the Chinese community. We assessed independent risk factors of uncontrolled blood pressure (defined as having a blood pressure ≥140/90 mmHg, even with antihypertensive therapy) and develop a risk prediction model.

Results: Among the 1,039 patients (53.9% male, the average age was 61 ± 13 years), 452 (43.5%) were uncontrolled hypertensive. Multivariable analysis showed that worker (odds ratio, OR: 1.98, 95% CI: 1.46-2.69), no health insurance (OR: 3.47, 95% CI: 2.08-5.80), non-marital status (OR: 2.01, 95% CI: 1.35-3.27), and other socio-behavioral aspects were independent risk factors of uncontrolled hypertension, which were included the final prediction model (C-static: 0.781). With internal validation by the bootstrap method, the risk score showed good discriminating ability and predicting ability for the incidence of uncontrolled hypertension (C-static: 0.771).

Conclusions: This study showed that nearly half of the patients suffered from uncontrolled hypertension in the Chinese community. We established a prediction model with good predictability to help quantify the combination of socio-behavioral aspects and screen high-risk patients with uncontrolled hypertension.