Construction and validation of a prediction nomogram for acute ischemic stroke in patients with H-type hyper-tension based on traditional chinese medicine syndromes
CHEN Xi
WANG Wen
HU Chuan-guo
Abstract：Objective To identify risk factors for acute ischemic stroke(AIS)in patients with H-type hyper-tension based on traditional Chinese medicine(TCM)syndromes and to develop a predictive nomogram model.Methods A total of 534 patients with H-type hypertension treated at Xinjiang Uygur Autonomous Region People's Hospital from January 2021 to June 2024 were enrolled and randomly divided into a modeling set(n=374)and a validation set(n=160)in a 7∶3 ratio.Patients in the modeling set were further classified into an AIS group and a non-AIS group.Baseline variables-including age,sex,residence,body mass index,homocysteine(Hcy)level,alcohol consumption,smoking history,hypertension grade,malnutrition,coronary artery disease,diabetes,lack of exercise,and TCM syndromes-were collected.Logistic regression analysis was employed to identify risk factors for AIS.A nomogram model incorporating TCM syndromes was constructed using R software(version 4.2.3)and subsequently validated.Results In the modeling set,63 of 374 patients developed AIS,yielding an incidence of 16.84％.Significant between-group differences were ob-served for Hcy levels,smoking history,hypertension grade,coronary artery disease,diabetes,and TCM syndrome types(P＜0.05),whereas other baseline characteristics showed no significant differences(P＞0.05).Logistic regression identified Hcy,smoking history,hypertension grade,coronary artery disease,diabetes,and the TCM syndrome of phlegm-dampness obstruction as independent risk factors for AIS(P＜0.05).The area under the ROC curve(AUC)of the no-mogram was 0.812(95％CI:0.752-0.872)in the modeling set and 0.888(95％CI:0.821-0.955)in the validation set.Calibration curves demonstrated strong agreement between predicted and observed outcomes.Decision curve analysis indicated that the nomogram offered substantial net clinical benefit across threshold probabilities of 1％-78％in the mod-eling set and 1％-96％in the validation set.Conclusion Elevated Hcy,smoking,higher hypertension grade,coronary artery disease,diabetes,and the TCM phlegm-dampness obstruction syndrome are significant risk factors for AIS in pa-tients with H-type hypertension.The TCM-based nomogram demonstrates strong predictive performance and clinical ap-plicability.
Keywords：syndrome types in Traditional Chinese MedicineH-type hypertensionacute ischemic strokeno-mogram model
Publication Date：2025-12-15
Online Publishing Date：2026-01-12(First online date of this platform, not the publication date of the document)
Pages：7( 1845-1851 )