Predicting Increased Blood Pressure Using Machine Learning

The present study investigates the prediction of increased blood pressure by body mass index (BMI), waist (WC) and hip circumference (HC), and waist hip ratio (WHR) using a machine learning technique named classification tree. Data were collected from 400 college students (56.3% women) from 16 to 63 years old. Fifteen trees were calculated in the training group for each sex, using different numbers and combinations of predictors. The result shows that for women BMI, WC, and WHR are the combination that produces the best prediction, since it has the lowest deviance (87.42), misclassification (.19), and the higher pseudo R 2 (.43). This model presented a sensitivity of 80.86% and specificity of 81.22% in the training set and, respectively, 45.65% and 65.15% in the test sample. For men BMI, WC, HC, and WHC showed the best prediction with the lowest deviance (57.25), misclassification (.16), and the higher pseudo R 2 (.46). This model had a sensitivity of 72% and specificity of 86.25% in the training set and, respectively, 58.38% and 69.70% in the test set. Finally, the result from the classification tree analysis was compared with traditional logistic regression, indicating that the former outperformed the latter in terms of predictive power.

[1]  Grant Smith,et al.  Obesity-induced Hypertension: Role of Sympathetic Nervous System, Leptin, and Melanocortins* , 2010, The Journal of Biological Chemistry.

[2]  Golino Hudson Men's dataset from the "Predicting increased blood pressure using Machine Learning" paper , 2013 .

[3]  E. Jackson,et al.  Estrogen-induced cardiorenal protection: potential cellular, biochemical, and molecular mechanisms. , 2001, American journal of physiology. Renal physiology.

[4]  F. Vadillo-Ortega,et al.  Obesity increases metabolic syndrome risk factors in school-aged children from an urban school in Mexico city. , 2007, Journal of the American Dietetic Association.

[5]  Leo Breiman,et al.  Random Forests , 2001, Machine Learning.

[6]  John E Hall,et al.  The kidney, hypertension, and obesity. , 2003, Hypertension.

[7]  M. Mason,et al.  Receiver-operating characteristics of adiposity for metabolic syndrome: the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study , 2010, Public Health Nutrition.

[8]  Wei-Yin Loh,et al.  Classification and regression trees , 2011, WIREs Data Mining Knowl. Discov..

[9]  K. Flegal,et al.  Prevalence and trends in obesity among US adults, 1999-2008. , 2010, JAMA.

[10]  Trevor Hastie,et al.  The Elements of Statistical Learning , 2001 .

[11]  Liping Lu,et al.  Can body mass index, waist circumference, waist-hip ratio and waist-height ratio predict the presence of multiple metabolic risk factors in Chinese subjects? , 2011, BMC public health.

[12]  B. Demirbaş,et al.  Relation of resistın wıth obesity and some cardiovascular risk factors in hypertensive women , 2012, Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences.

[13]  M. Abolfotouh,et al.  Prevalence of Metabolic Abnormalities and Association with Obesity among Saudi College Students , 2012, International journal of hypertension.

[14]  R. Pandey,et al.  Waist circumference cutoff points and action levels for Asian Indians for identification of abdominal obesity , 2006, International Journal of Obesity.

[15]  M. G. Ferreira,et al.  Association between anthropometric markers of body adiposity and hypertension in an adult population of Cuiabá, Mato Grosso , 2009 .

[16]  Renato Tinós,et al.  Using Machine Learning Classifiers to Assist Healthcare-Related Decisions: Classification of Electronic Patient Records , 2012, Journal of Medical Systems.

[17]  Gustavo Velasquez-Melendez,et al.  Epidemiologia do sobrepeso e da obesidade e seus fatores determinantes em Belo Horizonte (MG), Brasil: estudo transversal de base populacional , 2004 .

[18]  E. Ugwuja,et al.  Overweight and Obesity, Lipid Profile and Atherogenic Indices among Civil Servants in Abakaliki, South Eastern Nigeria , 2013, Annals of medical and health sciences research.

[19]  Pierre Geurts,et al.  Supervised learning with decision tree-based methods in computational and systems biology. , 2009, Molecular bioSystems.

[20]  P. O’Brien,et al.  Smaller Hip Circumference is Associated with Dyslipidemia and the Metabolic Syndrome in Obese Women , 2007, Obesity surgery.

[21]  T. Lohman,et al.  Anthropometric Standardization Reference Manual , 1988 .

[22]  G. Parati,et al.  Mechanisms of obesity-induced hypertension , 2010, Hypertension Research.

[23]  Michele Lessa de Oliveira Estimativa dos custos da obesidade para o Sistema Único de Saúde do Brasil , 2013 .

[24]  L. Landsberg Diet, obesity and hypertension: an hypothesis involving insulin, the sympathetic nervous system, and adaptive thermogenesis. , 1986, The Quarterly journal of medicine.

[25]  E. Adashi,et al.  Noncommunicable Diseases , 2015, Seminars in Reproductive Medicine.

[26]  A. Akintunde,et al.  Anthropometric differences among natives of Abuja living in urban and rural communities: correlations with other cardiovascular risk factors , 2013, BMC Research Notes.

[27]  A. Astrup,et al.  Obesity : Preventing and managing the global epidemic , 2000 .

[28]  J. Shaw,et al.  Waist circumference, waist–hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults , 2003, Journal of internal medicine.

[29]  Walter C Willett,et al.  Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. , 2005, The American journal of clinical nutrition.

[30]  P. Hertzman The cost effectiveness of orlistat in a 1-year weight-management programme for treating overweight and obese patients in Sweden , 2012, PharmacoEconomics.

[31]  John A. W. McCall,et al.  Machine learning for improved pathological staging of prostate cancer: A performance comparison on a range of classifiers , 2012, Artif. Intell. Medicine.

[32]  Ministério da Saúde,et al.  Vigitel Brasil 2011: Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico , 2012 .

[33]  Archana Bhattarai,et al.  Classification of Clinical Conditions: A Case Study on Prediction of Obesity and Its Co-morbidities , 2009 .

[34]  Parvez Hossain,et al.  Obesity and diabetes in the developing world--a growing challenge. , 2007, The New England journal of medicine.

[35]  Antonio Criminisi Machine learning for medical images analysis , 2016, Medical Image Anal..

[36]  Yang-Chu Lin,et al.  Obesity and the decision tree: predictors of sustained weight loss after bariatric surgery. , 2009, Hepato-gastroenterology.

[37]  M. Joffres,et al.  A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys , 2001, International Journal of Obesity.

[38]  J. Hall,et al.  Mechanisms of abnormal renal sodium handling in obesity hypertension. , 1997, American journal of hypertension.

[39]  Elisa T. Lee,et al.  Use of relative operating characteristic analysis in epidemiology. A method for dealing with subjective judgement. , 1981, American journal of epidemiology.

[40]  N. Leech,et al.  Problems With Null Hypothesis Significance Testing (NHST): What Do the Textbooks Say? , 2002 .