Predicting the Risk of Incident Hypertension in a Korean Middle‐Aged Population: Korean Genome and Epidemiology Study

The objectives of this study were to construct a risk score for predicting incident hypertension by using the Korean Genome and Epidemiology Study (KoGES) data and to compare the performance between KoGES and the Framingham model. A total of 4747 participants were analyzed. The entire cohort was randomly assigned to derivation and validation sets at a ratio of 6:4. A hypertension risk score was developed based on the derivation cohort, using the same risk factors that were used for developing the Framingham hypertension risk score. The accuracy of KoGES and Framingham models was evaluated in terms of calibration and discrimination. The area under receiver operating characteristic (AROC) curves were 0.789 for the Framingham model and 0.791 for the KoGES model. The AROC calculated for the point‐based risk score was 0.790, which is almost identical to that for the KoGES model. The Framingham model showed poor agreement (χ2=29.73, P=.0002) and underestimated the risk of hypertension in most deciles of predicted risk. The model based on KoGES yielded results similar to the observed risk of hypertension (χ2=4.17, P=.8415). This study demonstrates that the Framingham risk score based on data from a non‐Korean population can lead to the underestimation of the prediction risk of hypertension.