| アブストラクト | Antihypertensives are associated with increased risk of syncope, hypotension, and fractures, but the highest-risk individuals are unclear. This study aimed to develop and validate three models to predict these outcomes in patients with an indication for antihypertensive treatment. A cohort study was conducted using data from Clinical Practice Research Datalink (CPRD). Patients aged 40+ with systolic blood pressure 130-179 mmHg were included. Outcomes were first hypotension, syncope, or fracture leading to hospitalization or death within 10 years. Models were derived from CPRD GOLD data (n = 1,773,224) and validated with CPRD Aurum data (n = 3,805,366). Each model had 31-37 predictors. Validation demonstrated strong discriminative ability (10-year C-statistic: hypotension 0.824; syncope 0.819; fracture 0.790), with close agreement between predicted and observed risks for the hypotension and syncope models. Some underprediction was observed for the fracture model. These models could be used to help reassure patients about the relatively low risk of harm from antihypertensive treatment, or identify the small number of individuals with a higher risk where additional monitoring may be indicated. |
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| ジャーナル名 | Nature communications |
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| Pubmed追加日 | 2025/10/24 |
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| 投稿者 | Koshiaris, Constantinos; Wang, Ariel; Archer, Lucinda; Riley, Richard D; Snell, Kym Ie; Stevens, Richard J; Banerjee, Amitava; Swain, Subhashisa; Clegg, Andrew; Clark, Christopher E; Payne, Rupert A; Hobbs, F D Richard; Ogden, Margaret; McManus, Richard J; Sheppard, James P |
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| 組織名 | Nuffield Department of Primary Care Health Sciences, University of Oxford,;Oxford, UK. koshiaris.c@unic.ac.cy.;Department of Primary Care and Population Health, University of Nicosia Medical;School, Nicosia, Cyprus. koshiaris.c@unic.ac.cy.;Oxford, UK.;Department of Applied Health Sciences, The University of Birmingham, Birmingham,;UK.;National Institute for Health and Care Research (NIHR) Birmingham Biomedical;Research Centre, Birmingham, UK.;Institute of Health Informatics, University College London, London, UK.;Academic Unit for Ageing and Stroke Research, Bradford Institute for Health;Research, University of Leeds, Leeds, UK.;Exeter Collaboration for Academic Primary Care, University of Exeter Medical;School, St Luke's Campus, Magdalen Rd, Exeter, UK.;Patient and Public Advisor, Durham, UK.;Brighton and Sussex Medical School University of Brighton and University of;Sussex Brighton, Brighton, UK.;Oxford, UK. james.sheppard@phc.ox.ac.uk. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41130973/ |
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