Development of a machine-learning model for predicting arterial hypertension based on complete blood count parameters
https://doi.org/10.21886/2712-8156-2026-7-3-23-33
Abstract
Objective: development and evaluation of a machine learning model for predicting arterial hypertension using demographic characteristics and complete blood count parameters, and to assess the contribution of key predictors using interpretable methods. Materials and methods: we analyzed a dataset of 5,506 patients examined at the University Clinic of the Medical Research and Educational Institute of Lomonosov Moscow State University in 2021–2022 (2,256 men and 3,250 women, mean age 57.23±17.60 years). Arterial hypertension was identified in 3,697 (67%) individuals, while 1,809 (33%) formed the nonhypertensive group. Variables included sex, age, complete blood count parameters, and derived inflammatory indices (NLR, LMR, PLR). The proposed stacking model was compared with Lasso and Ridge regression, logistic regression, random forest, and gradient boosting. Model performance was assessed using the AUC. Results: AUC ranged from 0.75 to 0.77 for classic machine learning models, whereas the stacking model achieved an AUC of 0.99. The difference in AUC between the stacking model and alternative approaches was statistically significant (p<0.001), with a mean improvement of 22.9% compared with logistic regression. The leading markers were age and the erythrocyte indices RDW-SD, MCV, HGB, and MCH. Conclusion: based on internal validation, ensemble machine learning methods incorporating complete blood count parameters may improve the discriminative performance of cardiovascular risk prediction models; however, these performance estimates require confirmation through external validation in an independent cohort. Age and erythrocyte indices (RDW-SD, MCV, HGB, MCH) were the most informative predictors of arterial hypertension and may serve as accessible marker candidates for further research and improved risk stratification.
About the Authors
S. A. ZakharchukRussian Federation
Sofya A. Zakharchuk, student, Faculty of Medicine
Moscow
N. A. Mironov
Russian Federation
Nikita A. Mironov, Cand. Sci. (Med.), Assistant Professor, Senior Researcher
Moscow
A. G. Plisyuk
Russian Federation
Alina G. Plisyuk, Cand. Sci. (Med.), Associate Professor
Moscow
Ya. A. Orlova
Russian Federation
Yana A. Orlova, Dr. Sci. (Med.), Professor, Head of the Department of Age-Associated Diseases
Moscow
References
1. Obermeyer Z, Emanuel EJ. Predicting the Future - Big Data, Machine Learning, and Clinical Medicine. N Engl J Med. 2016;375(13):1216-1219. DOI: 10.1056/NEJMp1606181
2. Chen JH, Asch SM. Machine Learning and Prediction in Medicine - Beyond the Peak of Inflated Expectations. N Engl J Med. 2017;376(26):2507-2509. DOI: 10.1056/NEJMp1702071
3. Miotto R, Wang F, Wang S, Jiang X, Dudley JT. Deep learning for healthcare: review, opportunities and challenges. Brief Bioinform. 2018;19(6):1236-1246. DOI: 10.1093/bib/bbx044
4. Esteva A, Kuprel B, Novoa RA, Ko J, Swetter SM, Blau HM, et al. Dermatologist-level classification of skin cancer with deep neural networks. Nature. 2017;542(7639):115-118. Erratum in: Nature. 2017;546(7660):686. DOI: 10.1038/nature21056
5. Zhao H, Zhang X, Xu Y, Gao L, Ma Z, Sun Y, et al. Predicting the Risk of Hypertension Based on Several Easy-to-Collect Risk Factors: A Machine Learning Method. Front Public Health. 2021;9:619429. DOI: 10.3389/fpubh.2021.619429
6. Bagley SC, White H, Golomb BA. Logistic regression in the medical literature: standards for use and reporting, with particular attention to one medical domain. J Clin Epidemiol. 2001;54(10):979-985. DOI: 10.1016/s0895-4356(01)00372-9
7. Boateng EY, Abaye DA. A Review of the Logistic Regression Model with Emphasis on Medical Research. J Data Anal Inf Process. 2019;7(4):190-207. DOI: 10.4236/jdaip.2019.74012
8. Amini M, Zayeri F, Salehi M. Trend analysis of cardiovascular disease mortality, incidence, and mortality-to-incidence ratio: results from global burden of disease study 2017. BMC Public Health. 2021;21(1):401. DOI: 10.1186/s12889-021-10429-0
9. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation. 2019;139(10):e56-e528. Erratum in: Circulation. 2020;141(2):e33. DOI: 10.1161/CIR.0000000000000659.
10. Ma LY, Chen WW, Gao RL, Liu LS, Zhu ML, Wang YJ, et al. China cardiovascular diseases report 2018: an updated summary. J Geriatr Cardiol. 2020;17(1):1-8. DOI: 10.11909/j.issn.1671-5411.2020.01.001
11. Coronado F, Melvin SC, Bell RA, Zhao G. Global Responses to Prevent, Manage, and Control Cardiovascular Diseases. Prev Chronic Dis. 2022;19:E84. DOI: 10.5888/pcd19.220347
12. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599-3726. Erratum in: Eur Heart J. 2021;42(48):4901. DOI: 10.1093/eurheartj/ehab368.
13. Morrow DA, Cannon CP, Jesse RL, Newby LK, Ravkilde J, Storrow AB, et al. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Clinical characteristics and utilization of biochemical markers in acute coronary syndromes. Circulation. 2007;115(13):e356- 75. DOI: 10.1161/CIRCULATIONAHA.107.182882
14. Dobesh PP, Finks SW, Trujillo TC. Dual Antiplatelet Therapy for Long-term Secondary Prevention of Atherosclerotic Cardiovascular Events. Clin Ther. 2020;42(10):2084-2097. DOI: 10.1016/j.clinthera.2020.08.003
15. Ерина А.М., Ротарь О.П., Солнцев В.Н., Шальнова С.А., Деев А.Д., Баранова Е.И., и др. Эпидемиология артериальной гипертензии в Российской Федерации – важность выбора критериев диагностики. Кардиология. 2019;59(6):5-11.
16. Кобалава Ж.Д., Конради А.О., Недогода С.В., Шляхто Е.В., Арутюнов Г.П., Баранова Е.И., и др. Артериальная гипертензия у взрослых. Клинические рекомендации 2024. Российский кардиологический журнал. 2024;29(9):6117.
17. Ротарь О.П., Ильянова И.Н., Бояринова М.А., Могучая Е.В., Толкунова К.М., Дьячков В.А., и др. Результаты Всероссийского скрининга артериальной гипертензии 2023. Российский кардиологический журнал. 2024;29(5):5931.
18. Layton AT. AI, Machine Learning, and ChatGPT in Hypertension. Hypertension. 2024;81(4):709-716. DOI: 10.1161/HYPERTENSIONAHA.124.19468
19. Islam SMS, Talukder A, Awal MA, Siddiqui MMU, Ahamad MM, Ahammed B, et al. Machine Learning Approaches for Predicting Hypertension and Its Associated Factors Using Population-Level Data From Three South Asian Countries. Front Cardiovasc Med. 2022;9:839379. DOI: 10.3389/fcvm.2022.839379
20. Khamissi FZ, Sun L, Johnson P, Shah S, Benjamin IJ. Machine Learning and Artificial Intelligence for Research on Hypertension. Am J Hypertens. 2025;38(11):867-871. DOI: 10.1093/ajh/hpaf051
21. Guzik TJ, Nosalski R, Maffia P, Drummond GR. Immune and inflammatory mechanisms in hypertension. Nat Rev Cardiol. 2024;21(6):396-416. DOI: 10.1038/s41569-023-00964-1
22. Мордовин В.Ф., Зюбанова И.В., Манукян М.А., Доржиева И.К., Вторушина А.А., Хунхинова С.А., и др. Роль иммуновоспалительных механизмов в патогенезе артериальной гипертонии. Сибирский журнал клинической и экспериментальной медицины. 2023;38(1):21-27.
23. Поселюгина О.Б., Коричкина Л.Н., Стеблецова Н.И., Бородина В.Н., Данилина К.С., Маслов А.Н., и др. Показатели клинического анализа крови у больных с эссенциальной и ренопаренхиматозной артериальной гипертензией. Трудный пациент. 2021;19(2):14-17.
24. Бойцов С.А., Драпкина О.М., Шляхто Е.В., Конради А.О., Баланова Ю.А., Жернакова Ю.В., и др. Исследование ЭССЕ-РФ (Эпидемиология сердечно-сосудистых заболеваний и их факторов риска в регионах Российской Федерации). Десять лет спустя. Кардиоваскулярная терапия и профилактика. 2021;20(5):3007.
25. Schjerven FE, Ingeström EML, Steinsland I, Lindseth F. Development of risk models of incident hypertension using machine learning on the HUNT study data. Sci Rep. 2024;14(1):5609. DOI: 10.1038/s41598-024-56170-7
26. Zhan YL, Zou B, Kang T, Xiong LB, Zou J, Wei YF. Multiplicative interaction between mean corpuscular volume and red cell distribution width with target organ damage in hypertensive patients. J Clin Lab Anal. 2017;31(5):e22082. DOI: 10.1002/jcla.22082
27. Forrester SJ, Kikuchi DS, Hernandes MS, Xu Q, Griendling KK. Reactive Oxygen Species in Metabolic and Inflammatory Signaling. Circ Res. 2018;122(6):877-902. DOI: 10.1161/CIRCRESAHA.117.311401
28. Emamian M, Hasanian SM, Tayefi M, Bijari M, Movahedian Far F, Shafiee M, et al. Association of hematocrit with blood pressure and hypertension. J Clin Lab Anal. 2017;31(6):e22124. DOI: 10.1002/jcla.22124
29. Danese E, Lippi G, Montagnana M. Red blood cell distribution width and cardiovascular diseases. J Thorac Dis. 2015;7(10):E402-11. DOI: 10.3978/j.issn.2072-1439.2015.10.04
30. Chen Y, Hou X, Zhong J, Liu K. Association between red cell distribution width and hypertension: Results from NHANES 1999-2018. PLoS One. 2024;19(5):e0303279. DOI: 10.1371/journal.pone.0303279
31. He Z, Chen Z, Wang Y, Qin H, Wu W, Fu P, et al. Individual and joint effects of red blood cell traits on hypertension: a longitudinal analysis. Eur J Prev Cardiol. 2026;33(7):1140-1150. DOI: 10.1093/eurjpc/zwaf093
32. Миронов Н.А., Приезжев А.В., Свешникова А.Н., Луговцов А.Е., Каранадзе Н.А., Дячук Л.И., и др. Связь изменений микрореологии крови, системы гемостаза и функционального статуса пациентов с хронической сердечной недостаточностью: обоснование и протокол исследования. Кардиологический вестник. 2024;19(1):79-83.
33. Yu S, Xiong L, Wei D, Zhu H, Cai X, Shao L, et al. Prediction of the left ventricular mass index in hypertensive patients using the product of red cell distribution width and mean corpuscular volume. Medicine (Baltimore). 2024;103(14):e37685. DOI: 10.1097/MD.0000000000037685
34. Williams SK, Ravenell J, Seyedali S, Nayef S, Ogedegbe G. Hypertension Treatment in Blacks: Discussion of the U.S. Clinical Practice Guidelines. Prog Cardiovasc Dis. 2016;59(3):282-288. DOI: 10.1016/j.pcad.2016.09.004
35. Sheikhy A, Fallahzadeh A, Aghaei Meybodi HR, Hasanzad M, Tajdini M, Hosseini K. Personalized medicine in cardiovascular disease: review of literature. J Diabetes Metab Disord. 2021;20(2):1793-1805. DOI: 10.1007/s40200-021-00840-0
36. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11):e563-e595. Erratum in: Circulation. 2019;140(11):e647-e648. Erratum in: Circulation. 2020;141(4):e59. Erratum in: Circulation. 2020;141(16):e773. DOI: 10.1161/CIR.0000000000000677
37. Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227- 3337. Erratum in: Eur Heart J. 2022;43(42):4468. DOI: 10.1093/eurheartj/ehab484
Review
For citations:
Zakharchuk S.A., Mironov N.A., Plisyuk A.G., Orlova Ya.A. Development of a machine-learning model for predicting arterial hypertension based on complete blood count parameters. South Russian Journal of Therapeutic Practice. 2026;7(3):23-33. (In Russ.) https://doi.org/10.21886/2712-8156-2026-7-3-23-33
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