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Risk factors for hypertension in primary Sjögren’s syndrome patients: a nomogram was constructed

Journal of Human Hypertension volume 36, pages 996–1002 (2022)Cite this article

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Abstract

Cardiovascular disease (CVD) is one of the main causes of death in primary Sjögren’ s syndrome (pSS) patients, while hypertension is considered an independent risk factor for CVD in pSS patients and its prevalence is increased compared with the general population. In order to identify risk factors of hypertension in patients with pSS, this study included 293 pSS patients admitted in the Third People’s Hospital of Chengdu from April 2011 to August 2020 and 195 pSS patients admitted in Sichuan Provincial People’s Hospital from January 2011 to June 2018. The multiple logistic regression was used to screen risk factors and nomogram was drawn based on regression coefficients. Then C-index and calibration plot were used to estimate its discrimination and calibration, respectively. Compared with pSS patients without hypertension, those with hypertension were older, higher in blood pressure, longer in duration of pSS, and had higher rates of smoking, xerophthalmia, xerostomia, previous use of botanicals, NSAIDs, and statins. Moreover, they were more likely to have pulmonary interstitial fibrosis and had higher levels of serum lipids and renal function indicators (all P < 0.05). Finally, a nomogram based on four significant factors (age, duration of pSS, LDL-c, and anti-SSA antibody) was constructed. Its’ C-index is 0.812 (95% CI: 0.754–0.870), and it shows a good calibration. C-index value of 0.721 and good calibration still could be reached in external verification. Clinicians can use it in pSS population for early detection of hypertension and if necessary, early preventive measures could be taken to reduce its occurrence.

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Fig. 1: Flowchart showing the inclusion and exclusion of the subjects in study.
Fig. 2: The nomogram about the risk of hypertension in pSS patients.
Fig. 3: Example nomogram for risk of hypertension in a patient with pSS.
Fig. 4: Calibration curves of the nomogram prediction.

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Acknowledgements

We would like to thank all patients related, and the staff of department of Cardiology in the Third People’s Hospital of Chengdu and those of department of Geriatrics in Sichuan Provincial People’s Hospital, China.

Funding

This study was supported by funds from Sichuan Provincial Department of Science and Technology | Applied Basic Research Program of Sichuan Province (No.2021YJ0215), Sichuan Provincial Administration of Traditional Chinese Medicine Project (No.2020JC0010), Sichuan Provincial Department of Science, and Technology General Project (No.19YYJC0580).

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Author notes

  1. These authors contributed equally: Lin Cai, Han Wang.

Authors and Affiliations

  1. Department of Cardiology, The Affiliated Hospital of Southwest Jiaotong University/The Third People’s Hospital of Chengdu, Chengdu, China

    Xueping Xu, Xiaoqian Yang, Yiwen Zhang, Li Qin, Lin Cai & Han Wang

  2. College of Medicine, Southwest Jiaotong University, Chengdu, China

    Xueping Xu, Xiaoqian Yang, Yiwen Zhang, Li Qin, Lin Cai & Han Wang

  3. Department of Geriatrics, Sichuan Provincial People’s Hospital, Chengdu, China

    Yong Shi

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Contributions

HW and LC jointly conceived the study. XX, YS, XY, YZ and LQ collect relevant input data, XY, YZ, and LQ manage the visualization data. XX, HW and LC wrote code, ran the model, and analyzed output data. XX wrote the manuscript. YS wrote the Supplementary Information. All authors discussed the results and implications and commented on the manuscript at all stages.

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Correspondence to Lin Cai or Han Wang.

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The authors declare no competing interests.

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All clinical investigations were conducted according to the ethical guidelines of the Declaration of Helsinki (2001). Each patient provided written informed consent. All data were anonymized prior to analysis.

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Xu, X., Shi, Y., Yang, X. et al. Risk factors for hypertension in primary Sjögren’s syndrome patients: a nomogram was constructed. J Hum Hypertens 36, 996–1002 (2022). https://doi.org/10.1038/s41371-021-00603-7

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