Machine learning for predicting the outcomes and risks of cardiovascular diseases in patients with hypertension: results of ESSE-RF in the Primorsky Krai

Abstract

Aim. To assess the prospects of using artificial intelligence technologies in predicting the outcomes and risks of cardiovascular diseases (CVD) in patients with hypertension (HTN).Material and methods. A software application was created for data mining from respondent profiles in a semi-automatic mode; libraries with data preprocessing were analyzed. We analyzed the main and additional parameters (35) of CVD risk factors in 2131 people as a part of ESSE-RF study (2014-2019). To create a forecasting model, a high-level language Python 2.7 was used using object-oriented programming and exception handling with multithreading support. Using randomization, learning (n=488) and test (n=245) samples were formed, which included data from patients with an established diagnosis of HTN.Results. The prevalence of HTN among subjects was 34,39%. There were following significant factors for predicting CVD: anthropometric parameters, smoking, biochemical profile (total cholesterol, ApoA, ApoB, glucose, D-dimer, C-reactive protein). As a result of a 5-year follow-up, CVD was found in 235 people (32,06%) with HTN and 187 people (13,38%) without HTN; mortality rates were 1,27% in subjects with HTN and 1,12% — without HTN. The absolute mortality risk among participants with HTN (0,037) was significantly higher (p<0,05) than in patients without HTN (0,017). To create a neural network (NN), the basic Sequential model from the Keras library was used. During machine learning, 26 variables important for the CVD development were used as input and 9 neurons — as output, which corresponded to the number of established cardiovascular events. The created NN had a predictive value of up to 97,9%, which exceeded the SCORE value (34,9%).Conclusion. The data obtained indicate the importance of risk factor phenotyping using anthropometric markers and biochemical profile for determining their significance in the top 20 predictors of CVD. The Python-based machine learning provides CVD prediction according to standard risk assessments.